End-of-life treatment plans cut stress for families
Dying hospital patients who have provided clear instructions about end-of-life medical treatment leave behind loved ones who are less stressed, anxious and depressed, research from the Austin Hospital in Victoria, published in the British Medical Journal, has shown.
The Age reported that United States (US) President, Barack Obama, has used the Australian research to justify a new regulation that gets around the political storm over ”death panels”, which almost destroyed his attempts to overhaul the American health system.
The Austin study is described as the first to measure the value of end-of-life plans in hospitals.
These plans, which allow patients to write down preferred options for their future care, sometimes foregoing more aggressive treatments, sparked the “death panels” storm in the US, with critics concerned that government panels would decide who was worthy of care.
In the Austin study of 309 patients, all aged over 80, half went through the “intervention” of advance care planning, as the process is known in Australia, and the other half, the control group, did not.
For the 56 patients who died within six months, the relatives of those with end-of-life plans recorded significantly less stress, anxiety and depression than the relatives whose loved ones’ wishes were not known at the time of dying.
Study co-author and Austin intensive care specialist, Bill Silvester, said only the control group relatives, who had no clear instructions, showed evidence of clinically significant levels of anxiety, depression and post-traumatic stress disorder.
“If relatives knew what the patient wanted at the time they were dying they weren’t left stressed by having to guess what their loved ones would have wanted,” he said.
“They were simply fulfilling the wishes already expressed.”
Advance care planning is available to patients in 14 health services in Victoria under the Respecting Patient Choices program. A Department of Health working party of experts is developing a statewide policy for end-of-life plans.
