What is wrong with end-of-life care? Opinions of bereaved family members

Title

What is wrong with end-of-life care? Opinions of bereaved family members

Creator

Hanson LC; Danis M; Garrett J

Publisher

Journal Of The American Geriatrics Society

Date

1997

Subject

Female; Humans; Male; Physician-Patient Relations; Family; Home Nursing; Health Care Surveys; Attitude to Health; Aged; Attitude to Death; Communication; Respiration; Quality of Health Care; quality of life; Empirical Approach; Non-U.S. Gov't; Research Support; bereavement; Death and Euthanasia; cause of death; Nursing Homes/standards; Intensive Care/statistics & numerical data; Consumer Satisfaction/statistics & numerical data; North Carolina; Artificial/statistics & numerical data; Pain/nursing/therapy; Terminal Care/standards/statistics & numerical data

Description

OBJECTIVE: To describe family perceptions of care at the end of life. METHODS: In a representative sample of older people who died from chronic diseases, family members were interviewed about satisfaction with treatment intensity, decision-making, and symptom relief in the last month of life, and gave suggestions to improve care. RESULTS: Interviews were completed with 461 family members, 80% of those contacted. They reported that 9% of decedents received CPR, 11% ventilator support, and 24% intensive care during their last month of life. Family members could not recall a discussion of treatment decisions in 23% of cases. Presence or absence of a living will did not affect the likelihood of no discussion (22% vs 24%, P = .85). Family informants desired more treatment to sustain life in 8% of deaths. They or the decedent wanted treatments doctors did not recommend in 6% of deaths but refused recommended therapies in 18% of deaths. They believed more care to relieve pain or other symptoms was indicated in 18% of deaths. Asked to make positive or negative comments about any aspect of terminal care, 91% of comments on hospice were positive. Nursing home care received the smallest proportion of positive comments (51%). Family members recommendations to improve end of life care emphasized better communication (44%), greater access to physicians' time (17%), and better pain management (10%). CONCLUSION: Bereaved family members are generally satisfied with life-sustaining treatment decisions. Their primary concerns are failures in communication and pain control. Discussions that focus on specific treatment decisions may not satisfy the real needs of dying patients and their families.
1997

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

1339-1344

Issue

11

Volume

45

Citation

Hanson LC; Danis M; Garrett J, “What is wrong with end-of-life care? Opinions of bereaved family members,” Pediatric Palliative Care Library, accessed September 21, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11928.

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