{"id":34785,"date":"2017-12-04T12:16:41","date_gmt":"2017-12-04T07:16:41","guid":{"rendered":"https:\/\/tns.world\/?p=34785"},"modified":"2017-12-04T12:16:41","modified_gmt":"2017-12-04T07:16:41","slug":"doctors-rarely-discuss-end-of-life-care-for-chronic-lung-conditions","status":"publish","type":"post","link":"https:\/\/tns.world\/?p=34785","title":{"rendered":"Doctors rarely discuss end-of-life care for chronic lung conditions"},"content":{"rendered":"

COLORADO Dec 04 (TNS):<\/strong> Though most people suffering from chronic respiratory diseases want to discuss their preferences for end-of-life care with medical providers, they seldom do, a new review of past research suggests.<\/p>\n

\u201cIt\u2019s easier to avoid the conversation, which is rarely a brief one,\u201d said Dr. Cari Levy, a professor at the University of Colorado Anschutz Medical Campus in Aurora. \u201cOur systems are not designed to allow for meaningful conversations that may take some time.\u201d<\/p>\n

Levy, a palliative-care physician who routinely discusses end-of-life questions with her patients, believes that confronting death can be empowering.<\/p>\n

\u201cWe should not fool ourselves that protecting them from these discussions is in their best interest because we don\u2019t want them to lose hope,\u201d Levy, who was not involved with the study, said in an email. \u201cIt\u2019s hard to have hope when you\u2019re mired in a cloud of anxiety. Clarity comes with control, and patients report feeling more control when they talk about dying and death.\u201d<\/p>\n

Lea Jabbarian, a public health researcher at Erasmus University Medical Centre in Rotterdam, The Netherlands, led a team that searched electronic databases for research on advanced-care planning in adults with chronic respiratory diseases.<\/p>\n

Ultimately, the researchers looked at data from 21 earlier studies involving nearly 2,000 patients with chronic lung diseases.<\/p>\n

In one of the studies, 99 percent reported being interested in discussing end-of-life care preferences, Jabbarian and colleagues report in the journal Thorax.<\/p>\n

In another study, focusing on chronic obstructive pulmonary disease, 68 percent of people reported being interested in engaging in conversations about the subject.<\/p>\n

But when investigators asked chronic respiratory patients if they could recall discussions about end-of-life care with their healthcare providers, only 12 to 32 percent said they could. Similarly, when researchers asked healthcare professionals if they had engaged patients in such discussions, only 20 to 33 percent reported doing so.<\/p>\n

\u201cWe see that both patients and healthcare professionals want to have these conversations, but they only happen quite rarely,\u201d Jabbarian said in a Skype interview. \u201cWe need to provide the right training, the right environment to allow these conversations to happen.\u201d<\/p>\n

\u201cIt\u2019s really not that easy, and that\u2019s why the healthcare professionals need all the support to engage in these discussions. We do have to acknowledge that life is going to end at some point,\u201d she said.<\/p>\n

Healthcare professionals identified time constraints and fear of taking away patients\u2019 hope as barriers to engaging in conversations with patients about their end-of-life care preferences. Other barriers included a \u201ccure-at-all-costs\u201d ethos, a lack of training for communicating about end-of-life care options and a failure to identify whose role it was to initiate a conversation.<\/p>\n

\u201cWho\u2019s the captain on the ship?\u201d Jabbarian asked. \u201cIt\u2019s difficult to take the responsibility.\u201d<\/p>\n

As a palliative-care doctor, Levy routinely opens discussions about end-of-life care. Because she knows there is never a perfect time to start the conversation, she advises healthcare professionals to begin a dialogue as soon as possible.<\/p>\n

\u201cDo as your mother did and rip off the Band-Aid \u2013 the anticipation is the hardest part,\u201d she said.<\/p>\n

She listens for openings in conversations, like when patients say things like, \u201cI\u2019m so tired of being sick,\u201d or \u201cI didn\u2019t know if I would ever get well again after that last time.\u201d<\/p>\n

The most important part of the conversation is taking the time to hear what a patient has to say, she said.<\/p>\n

But the most productive and revealing conversations about end-of-life wishes often take place outside of hospitals and clinics and around dinner tables, Levy said.<\/p>\n

\u201cI do think we place too much emphasis on making healthcare environments the place for these conversations,\u201d she said. \u201cCommunities are a lovely place to talk about what matters most in the event of illness. At the Thanksgiving dinner, the holiday festivities when everyone is together, these are times to discuss what matters to you.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

COLORADO Dec 04 (TNS): Though most people suffering from chronic respiratory diseases want to discuss their preferences for end-of-life care with medical providers, they seldom do, a new review of past research suggests. \u201cIt\u2019s easier to avoid the conversation, which is rarely a brief one,\u201d said Dr. Cari Levy, a professor at the University of […]<\/p>\n","protected":false},"author":1,"featured_media":34786,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1226,19],"tags":[1227,733],"class_list":["post-34785","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-colorado","category-world","tag-colorado","tag-world"],"_links":{"self":[{"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/posts\/34785","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tns.world\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=34785"}],"version-history":[{"count":1,"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/posts\/34785\/revisions"}],"predecessor-version":[{"id":34787,"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/posts\/34785\/revisions\/34787"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tns.world\/index.php?rest_route=\/wp\/v2\/media\/34786"}],"wp:attachment":[{"href":"https:\/\/tns.world\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=34785"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tns.world\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=34785"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tns.world\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=34785"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}