Study: End-of-Life Conversations Make a Difference
End-of-life (EOL) conversations enhance palliative care and quality-of-life efforts for nursing home residents, according to a study in the March issue of JAMDA.
In “Association Between End-of-Life Conversations in Nursing Homes and End-of-Life Care Outcomes: A Systematic Review and Meta-analysis,”—which was part of the issue’s special End of Life Care section—the authors reviewed articles in the scientific/medical literature focusing on the impact of EOL conversations on outcomes. They found relevant studies showed that EOL conversations between health care professionals and family members were positively associated with family decisions to limit or withdraw life-sustaining treatments, fewer in-hospital deaths, fewer unplanned hospital admissions, shorter lengths of hospital stays, family satisfaction with EOL care, and increased odds of receiving strong opioid analgesics in the last 24 hours of life. The authors also found that EOL care satisfaction increased with the duration and frequency of EOL conversations.
The authors concluded that “health care professionals-family EOL conversations may promote a palliative care approach in NH residents with less aggressive treatments regardless of the social, geographical, and cultural contexts.” They acknowledged that these discussions can be “emotionally challenging” for health care practitioners. However, they stressed that “timely, sensible communication” is necessary to ensure quality care. They also observed that a clear explanation of treatment choices by the physician “was associated with a dignified death according to families.”
This study was conducted by researchers at the Department of Biomedicine and Prevention, University of Roma Tor Vergato, Roma, Italy; Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy; Department of Public Health and Pediatric Sciences, University of Torino; Research and Third Mission Area, University of Tornio; and Department of Clinical and Biological Sciences, University of Torino.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PA/LTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.