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End-of-Life Talks Between Elderly, Doctors Inadequate

Most patients consider end-of-life care pre-hospitalization, appoint surrogate decision maker

TUESDAY, April 2 (HealthDay News) -- Most elderly patients at high risk for imminent death and their family members are discussing end-of-life (EOL) treatment preferences, but many do not communicate these with a member of the health care team, according to a study published online April 1 in JAMA Internal Medicine.

Daren K. Heyland, M.D., from Queen's University in Canada, and colleagues surveyed 278 elderly patients (mean age, 80.0 years) who were at high risk of dying in the next six months and their 225 family members (mean age, 60.8 years) at 12 acute care hospitals in Canada.

The researchers found that 76.3 percent of patients had thought about EOL care before hospitalization, with only 11.9 percent preferring life-prolonging care. Just under half of patients (47.9 percent) had completed an advance care plan, and most (73.3 percent) had formally named a surrogate health care decision maker. However, only 30.3 percent of patients who had discussed their wishes had done so with their family physician or with any member of the health care team (55.3 percent). In 30.2 percent of cases, there was agreement between patients' expressed EOL care preferences and documentation in the medical record. Family members and patients generally had similar perspectives.

"For the most part, these patients and their family members have considered their wishes for medical treatments at the EOL, but there has been very little communication with health care professionals (either before or during hospitalization) and inadequate documentation of these wishes," write the authors.

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