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Oral Abstracts - Workshop Session 2
Opportunities to improve end-of-life communication and decision-making for seriously ill hospitalised patients and their families
  1. JJ You*1,
  2. DK Heyland2,
  3. P Dodek3,
  4. F Lamontagne4,
  5. D Barwich5,
  6. C Tayler5,
  7. P Porterfield3,
  8. J Simon6 and
  9. Bert Enns6
  1. 1McMaster University, Hamilton
  2. 2Queen's University, Kingston
  3. 3University of British Columbia, Vancouver
  4. 4Université de Sherbrooke, Sherbrooke
  5. 5Fraser Health Authority, Surrey
  6. 6University of Calgary, Calgary; all in Canada

Abstract

In face-to-face interviews with seriously ill patients and/or their family members, we used a validated questionnaire to assess key components of in-hospital end-of-life (EOL) communication and decision-making at 11 Canadian hospitals. We report preliminary data from 123 seriously ill hospitalised patients (age 80±9 years, mean±SD) and 77 family members (age 62±13 years). Patients rated being comfortable and minimising suffering as 8.8±2.5 (1=not at all important; 10=very important) and avoidance of being attached to machines as 7.5±3.5. Nearly 50% of participants reported that a decision was made in hospital about the use of life-sustaining treatments (LST) in the event of a life-threatening deterioration. However, when patients were asked about EOL communication with their in-hospital care providers, only 8 (6.5%) reported receiving a disclosure of prognosis, 37 (30.1%) received information about comfort measures to control symptoms, 15 (12.2%) were asked what was important to them when considering decisions about EOL care, and 16 (13.0%) had discussed the risks and benefits of life-sustaining treatments (LST) with a physician. In family members who were asked about EOL communication regarding their relative (the patient), 12 (15.6%) received a disclosure of prognosis, 24 (31.2%) received information about comfort measures, 12 (15.6%) were asked what was important to them when considering decisions about EOL care for their relative, and 11 (14.3%) had discussed risks and benefits of LST with a physician. There are many opportunities to improve the quality of EOL communication and decision-making with seriously ill hospitalised patients and their families.

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