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Advance planning improves end of life care, reduces carer stress

05/06/2010 - Articles

Advance planning improves end of life care, reduces carer stress

By: Susan Aldridge, medical journalist, PhD

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End of life care is something both patients and doctors need to think about, particularly when a terminal illness is involved. End of life care involves issues like taking decisions about medical treatments in advance and whether to appoint a person to make decisions for the patient when they cannot do so for themselves. Clearly, these are questions that need to be decided before end of life care actually begins. And, surprisingly perhaps, there have been no trials on the effect this kind of advance planning has in end of life care.

Researchers in Australia set out to test the theory that careful advance planning would improve end of life care and the way relatives viewed it. A total of 155 patients admitted to a large university hospital in Melbourne were assigned to usual care and acted as controls. A group of 154 patients received advance care planning from a group of trained, but non-medical, facilitators. The advance care planning involved getting patients to reflect on goals, beliefs and values, their medical treatment preferences for end of life care, appointing someone to act for them and then documenting their wishes.

Then patients were followed up for six months or until their death. Of the 56 patients who died at six months, end of life care wishes were known and followed in 86% who’d been in the planning group but only in 30% of those who’d been in the control group. Furthermore, the relatives of patients in the intervention group experienced much less stress, anxiety and depression over the death than those in the control group. Patient and family satisfaction was also much higher in the intervention group. Therefore, advance planning for end of life care has many positives and should be introduced more widely.

 

Source:

Detering K et al BMJ Online 24th March 2010 BMJ 2010:340c1345

 

Created on: 05/06/2010
Reviewed on: 05/06/2010

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