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End-of-Life Care Discussions May Miss Patient Priorities

Discussion of care preferences, prognosis, values, and fears important to patient and family

MONDAY, Nov. 3, 2014 (HealthDay News) -- Important points are often missed when doctors have end-of-life discussions with patients and their families, according to a study published online Nov. 3 in CMAJ, the journal of the Canadian Medical Association.

Researchers asked 233 older Canadians who were hospitalized with serious illnesses and 205 of their family members about the importance of 11 guideline-recommended elements of end-of-life care.

The researchers found that patients reported 1.4 (standard deviation, 2.4; median, 0) of the 11 recommended elements of end-of-life care had been discussed with them during the first few days after they were admitted to hospital. Patients and families said the top five end-of-life issues that should be addressed were: care preferences in the event of life-threatening illness; patient values; prognosis of illness; fears and concerns; and additional questions regarding care. However, according to the researchers, doctors often didn't discuss these issues. The more elements of end-of-life care that doctors discussed with patients, the higher the level of satisfaction with care reported by patients and their families.

"Our findings could be used to identify important opportunities to improve end-of-life communication and decision-making in the hospital setting," study lead author John J. You, M.D., of McMaster University in Hamilton, Canada, said in a journal news release.

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