Planning Improves Compliance With End-of-Life Wishes

Study also finds planning helps families cope by lessening stress, anxiety and depression
By Jeff Muise
HealthDay Reporter

WEDNESDAY, March 24 (HealthDay News) -- Elderly people who have formal end-of-life planning are more likely to have their wishes followed and their families better prepared than people who do not plan ahead, according to a study published online March 23 in BMJ.

Karen M. Detering, M.D., of Austin Health in Heidelberg, Australia, and colleagues randomized competent subjects 80 years or older to receive usual care (control group) or usual care plus advance care planning using the Respecting Patient Choices model, which includes discussion of goals and values, medical treatment preferences, life prolongation, resuscitation, appointment of a surrogate, and other issues. Study outcomes included the proportion of patients whose end-of-life wishes were followed, as well as patient and family satisfaction and the family's levels of stress, anxiety and depression.

The researchers found that 81 percent of the intervention group received advance care planning, with 86 percent of those expressing a wish for and/or appointing a surrogate. Of the 56 patients in both groups who died by six months, 86 percent in the intervention group had their end-of-life wishes known and followed compared to 30 percent in the control group. Also, families of intervention-group patients who died reported less stress, anxiety and depression than families of those in the control group. Patients and family members in the intervention group also reported higher satisfaction.

"This randomized, controlled trial shows that advance care planning carried out properly by trained non-medical staff improves end-of-life care by enabling patients' wishes to be determined, documented, and respected at end of life," the authors write.

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