How to talk to patients about end-of-life care

Structured guide aims to prepare physicians, patients

A new "conversation guide" in the Canadian Medical Association Journal aims to facilitate end-of-life discussions between physicians, patients, and their family members in a hospital setting.

As the population ages and individuals are living longer with chronic conditions, it is increasingly important that patients and their family members be aware of end-of-life care options, according to McMaster University's John You and colleagues.

Moreover, they argue that it is crucial for physicians to learn how to address the issue sensitively. The structured conversation guide aims "to increase clinicians' confidence in engaging in meaningful end-of-life communication with patients in hospital and their family members," they wrote.

  • The authors proposed a framework that will help inform decisions based on:
  • Identifying patients at risk of dying;
  • Communicating prognosis;
  • Clarifying patient values around the care plan;
  • Involving family members in care planning; and
  • Documenting a patient's wishes.

They also called on physicians to "exercise judgment and flexibility in engaging patient and family members in these discussions, recognizing that determining goals of care is a process," noting that the process may be "straightforward" for some, while others may be "less prepared."

Additionally, the authors suggest efforts to increase public awareness about the important of advance end-of-life planning and the limitations of life-sustaining treatment (Medical News Today, 7/15).

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