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16-05-2011 | Hospice medicine | Article

Education in end-of-life planning may help patients make informed decisions


Free abstract

MedWire News: A US study suggests that educating patients on options for care at the end of their lives can lead to greater planning for this scenario, increase the use of hospices, and improve outcomes for individuals.

Previous knowledge and experience of end-of-life care were associated with favorable attitudes in planning for this eventuality, with education and age also playing a role, the findings show.

End-of-life planning is known to result in patients' care more closely matching their wishes and a decrease in unwanted resuscitations, as well as giving families higher satisfaction with care and often resulting in decreased healthcare costs, say the researchers.

Noting that little is known about factors that affect end-of-life decisions and planning, they asked a random sample of ethnically diverse residents of South Florida aged 18 years and older to anonymously complete a questionnaire on the issue.

The 331 eligible responses showed that a more positive attitude toward hospices was associated with older age and having a greater prior knowledge of living wills, hospice services, and a higher level of education.

Older age, no religious affiliation, and having prior knowledge of living wills were associated with preferences for less intensive medical interventions at the end of life.

Having a living will, prior knowledge of hospices, and a higher level of education were also associated with being more comfortable communicating about death and dying.

Neither race nor ethnicity appeared to be associated with these results, report Robin Jacobs and colleagues from Nova Southeastern University in Fort Lauderdale in the American Journal of Hospice and Palliative Medicine.

They conclude: "Patient education and counseling on end-of-life issues that include discussing end-of-life care options (ie, hospices) and things they can do to assure their wishes and rights are upheld (ie, living wills and healthcare power of attorney) may help patients make informed decisions about end-of-life issues.

"Initiating discussions about death and dying and end-of-life options with younger or middle-aged patients and not just the elderly may also yield better long-range planning for all healthcare consumers."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Anita Wilkinson

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