Survey: Patients, Physicians Not Discussing End-of-Life Care

TOPIC ALERT:

Most Californians would want to discuss end-of-life care options with their physicians if they were seriously ill, but very few have had such a conversation, according to a survey from the California HealthCare Foundation, the Contra Costa Times reports.

CHCF publishes California Healthline (Krieger, Contra Costa Times, 2/14).

For the survey -- which was conducted last fall -- research firm Lake Research Partners interviewed 1,669 Californians ages 18 and older, 393 of whom had experienced the death of a loved one in the past 12 months.

Key Findings

About 80% of Californians said they would want to discuss end-of-life care with their physician if they had a serious illness, the survey found.

However, only 7% said they have taken part in such a discussion, including only 13% of residents ages 65 and older.

The study also found that:

  • 82% of respondents said it is important to have their end-of-life wishes in writing, but only 23% have drafted such a plan;
  • 70% of respondents said they would prefer to die at home, but only 32% have made such arrangements;
  • About 66% of respondents said they would prefer a natural death if severely ill, and only 7% would want health providers to take all necessary measures to prolong their lives; and
  • 44% of those who recently had experienced the death of a loved one said the person's end-of-life care preferences had been followed completely by health care providers.

Implications

The survey results demonstrate the need for more physicians to talk to patients about options for end-of-life care, according to the San Francisco Chronicle.

Findings also suggest that Californians should make their wishes for end-of-life care known to loved ones who will be making treatment decisions on their behalf (Colliver, San Francisco Chronicle, 2/14).

susan smith
This is a very important conversation that may save a lot of anguish - emotional and financial - for the family. Some states offer simple forms that you can fill out and keep in your records denoting exactly what you want - or don't want - done during the end of your life. And they walk you through some scenarios that are worth contemplating. Physicians are required to follow these directives.
Barbara Hanson
Related to this end-of-life issue is long-term care plans. The government is predicting 70% of those turning 65+ every 10 seconds will, at some point, need long-term care services. Fewer than 10% of those who could afford LTC insurance have it, and I am pretty sure even fewer have any written and agreed to document on who will be their caregiver, where they will wish to live and which of their savings accounts will be the first tapped for expenses. This document could be part of our estate planning preparations, on file w/ lawyers in your will/trust. Also, the daughter you assume will come forward for your 24/7 care needs to see and sign that she will make herself available.
James Roache PharmD
In these changing times it is becoming more difficult for patients to even identify "their doctor" let alone the doctor having the time or inclination for such important discussions. The reported figures appear somewhat contradictory in that only 7% had such an end of life discussion, yet 44% received their preferences by a healthcare professional. Hospice most likely played a major role in this group, however, hospice requires an order from the physician based on pre-determined criteria indicating those 44% did in fact have some discussion with their doctor.

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