The CONVERSATION: How Do You Want to Die (adapted)

In one study of seriously ill older Canadians, 28 per cent of participants wanted “comfort care” (meaning no curative treatments) but this was documented in only four per cent of their charts. (Shutterstock)

Poor communication is compromising care for the dying
April 19, 2018 9.14am AEST
John You

Research shows that up to 70 per cent of seriously ill, hospitalized elderly Canadians are receiving invasive end-of-life treatments that they don’t want. This could be your mother or your grandfather. Maybe someday, it will be you.

For more than 10 years, the team of health researchers, Canadian researchers at end-of-life network or CARENET, has been working to understand and improve palliative and end-of-life care in Canada.
We know that many older patients with serious illness want to maintain quality of life rather than prolong it. However, the use of aggressive life-sustaining technologies in this vulnerable population is common.

Instead of a peaceful end-of-life experience, they are receiving invasive medical treatments during their last days.

A national, multi-year study involving seriously ill older Canadians revealed that even though 28 per cent of the participants stated a preference for “comfort care” (meaning no curative treatments), this was documented in only four per cent of their charts.

This discrepancy can lead to a poor end-of-life experience and an increase in family distress.

Why is this happening? Often, it comes down to a lack of communication. Even though studies have shown that seriously ill patients and families have identified end-of-life communication and decision-making as high priority targets for quality improvement, these conversations are typically “too little, too late and not great.”

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