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Patients Benefit From End-of-Life Discussions With a Doctor
Date:10/7/2008

0.8 percent versus 6.7 percent) and admission to the intensive care unit (4.1 percent versus 12.4 percent). These patients also enrolled in a hospice earlier; longer hospice stays were associated with better quality of life, while aggressive medical care had the opposite effect, the study found.

Meanwhile, caregivers were significantly less likely to experience major depressive disorders if the loved one did not die in an intensive care unit.

One previous study, published last year in the New England Journal of Medicine, had found that when doctors spend 10 minutes more than usual listening to the families of people dying in the intensive care unit and provide them with a brochure on bereavement, those family members are far less likely to suffer from stress, anxiety or depression after the death of their loved one.

"This really highlights the importance of patients having end-of-life discussions with a health-care professional," said Dr. Robert McCann, professor of medicine at the University of Rochester School of Medicine and Dentistry and chief of medicine at Highland Hospital in Rochester, N.Y. "Just by having discussions -- we don't know anything about the quality of the discussion or what was said -- led patients to better choices, things that would make a bigger difference in quality of life."

For the physician, Wright said: "It's important to have a healthy dose of empathy and frank truth, ask the patient if they have thought about what this really means. Mental and physical health often deteriorate rapidly at the end, and this can leave health-care providers and loved ones wondering what the patient would have wanted."

More information

The National Hospice and Palliative Care Organization has more on end-of-life care.



SOURCES: Alexi A. Wright, M.D., hematology-onc
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