scholarly journals Initiating End-of-Life Discussions With Seriously Ill Patients

JAMA ◽  
2000 ◽  
Vol 284 (19) ◽  
pp. 2502 ◽  
Author(s):  
Timothy E. Quill
Author(s):  
Mary McKenzie ◽  
Kelly Vranas ◽  
Elizabeth Cooney ◽  
Tatiana Silva ◽  
Susan Metzger ◽  
...  

Pained ◽  
2020 ◽  
pp. 217-218
Author(s):  
Michael D. Stein ◽  
Sandro Galea

This chapter discusses the planning for end-of-life care. Results of a 2017 survey show that older adults are likelier than younger people to have documented their end-of-life wishes. Yet few adults with or without written documents have discussed end-of-life care with their doctors. Age, education, and discussions about death were predictors of having such a plan. Those with a college education or higher were most likely to have a written document, compared to those with some college, high school, or less education. Also, talking about death while growing up correlated with having written documents about wishes for medical care. Care settings encouraging or mandating doctors to use an advanced directive toolkit, such as the one created by the National Physician Orders for Life-Sustaining Treatment Paradigm, can improve the communication gap with providers and help seriously ill patients better express their wishes for end-of-life care.


JAMA ◽  
2001 ◽  
Vol 285 (22) ◽  
pp. 2906 ◽  
Author(s):  
Steven Z. Pantilat

Author(s):  
Ravi B. Parikh ◽  
Oreofe O. Odejide

The chapter describes the national survey study by Steinhauser and colleagues, which assessed perspectives of seriously ill patients, family members, physicians, and other care providers (i.e., nurses, social workers, and chaplains) regarding the importance of several factors at the end of life. Survey respondents were asked to rate and rank the importance of attributes of quality at the end of life. This chapter highlights attributes that met consensus among all groups of respondents, those that were important to patients but not physicians, and attributes that had broad variation across all groups. It also includes items that were ranked the most important and least important by all groups. This chapter emphasizes areas of agreement as well as areas of diversity in the definition of a “good death” and discusses implications of these findings in providing end-of-life care.


2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 19-19
Author(s):  
Anna Catherine Beck ◽  
Allison Miraglia ◽  
Deepthi Rajeev ◽  
Rita Hanover ◽  
Joshua Steenstra ◽  
...  

19 Background: Studies recommend improved attention to patient end-of-life (EOL) care preferences and there is evidence that effective provider-patient EOL care conversations yield positive patient outcomes and reduce stress, anxiety, and depression for providers. Providers lack training to elicit patients’ EOL care goals and hence are reluctant to initiate EOL conversations. Methods: The Serious Illness Conversation Guide (SICG) was used to train providers and data were collected based on the Maslach Burnout Inventory to assess provider burnout, determine satisfaction of SICG training, and change in confidence/knowledge related to EOL conversations. Results: 18 providers were trained with a median work experience of 15 years. 41% spent 8+ hours/week interacting with seriously ill patients, 50% initiate EOL conversations < twice/month, and 19% reported burnout. 10 providers responded to the post-training evaluation, 80% reported burnout (Table). Conclusions: Providers reported high satisfaction of SICG training and increased knowledge and confidence related to EOL care conversations. However, provider burnout increased, possibly due to their increased awareness of an appropriate way to elicit patients’ EOL care goals. To explore this further, we will be conducting additional training sessions in the future. [Table: see text]


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