A study published in JNCCN, Journal of the National Comprehensive Cancer Network, finds a vast majority of patients would like their doctor to ask them about their preferences for end-of-life care.
This is at odds with the fact that less than 10 percent had spoken with their physician about details such as where they would like to die, according to the survey. The researchers found that patients are more likely to spend their final days in a costly hospital environment, despite preferring to be at home or in a hospice facility.
The study was led by Amy Waller, of the Health Behavior Research Group at the University of Newcastle, in Australia. The researchers distributed a paper survey to patients in the waiting room of an oncology outpatient clinic. A total of 203 participants provided survey answers. Of those, 87 percent said they wanted their doctor to ask them about their end-of-life care location, while only 7 percent had actually had that conversation.
Forty-one percent of respondents had discussed their preferences with a support person. Forty-seven percent responded to the survey by stating they would wish to remain at home, 34 percent preferred a hospice/palliative care unit, and just 19 percent would prefer a hospital.
However, a multi-national study found that among cancer patients, between 12 percent and 57 percent spend their final moments at home, while between 22 percent and 78 percent are in hospitals.
Given the sensitive nature of any discussion around end-of-life care, questions remain as to how exactly doctors should start these types of conversations.
In the JNCCN article, the researchers recommend using communication tools such as question prompt lists and hypothetical scenarios to introduce various end-of-life settings as a way of jump-starting this important discussion. Complimentary access to the study, “The Right Place at the Right Time: Medical Oncology Outpatients’ Perceptions of Location of End-of-Life Care” is available until March 11, 2018 at JNCCN.org.
