Disease Type May Dictate Quality Of End-Of-Life Care: Study
28 June 2016, 8:27 am EDT By Katherine Derla Tech Times
Patients suffering from dementia or cancers may receive more end-of-life care compared with people dying from other diseases. Findings suggest that illness type may dictate the quality of care dying patients receive. ( Theo Heimann | Getty Images )
New research from the Veteran Affairs hospitals found that disease type may dictate the quality of end-of-life care among patients.
The findings showed that there were fewer dementia and cancer patients who died in intensive care units (ICUs).
This is because many of these patients had increased end-of-life planning and comforting care, including orders not to resuscitate, compared with other dying individuals with different diseases.
In the study, "other illnesses" included frailty, heart failure, lung disease and end-stage kidney disease.
According to the study's lead researcher Dr. Melissa Wachterman, historically, end-of-life care improvements concentrated on cancer. In recent years, more efforts were made for the benefits of dementia patients.
"We really do need to expand efforts to improve care to other patients that haven't gotten that focus," added Wachterman, who is an assistant professor of medicine at Brigham and Women's Hospital and the VA Boston Healthcare System.
Wachterman highlighted that apart from cancer patients who are facing death, many patients suffering from other illnesses such as kidney disease, heart disease, lung disease and frailty are also dealing with fatal conditions.
According to the U.S. National Institutes of Health, "palliative care" is a treatment method that is focused on easing patients' symptoms as well as improving their quality of life. This type of approach is designed for patients dealing with fatal illnesses.
The palliative care approach also offers loved ones and families the support system they need to care for a fatally or seriously ill individual.
While hospice care is a similar approach, it usually begins when treatments for the illness stop. Palliative care can be done side by side with curative care.
For the study, the researchers analyzed data from 146 VA health system hospitals using medical archives and Bereaved Family Survey results. The team looked into the data of nearly 58,000 patients who died from 2009 to 2012.
They found that among patients who suffered from frailty, heart disease, lung disease and kidney disease, only 50 perceived had palliative care discussions. In comparison, more cancer patients (75 percent) and dementia patients (61 percent) received the said consultations.
"Most people don't die of cancer, but the palliative care of those dying from other diseases is not as good. But palliative care and hospice can help a lot," said Wachterman.
Nearly one-third of kidney failure, heart failure and frailty patients died in ICUs. On the other hand, only 13 percent of cancer and 9 percent of dementia patients died in ICUs.
The team also found that 94 percent of dementia and cancer patients had "Do Not Resuscitate (DNR)" orders. Among patients with other illnesses, only 87 percent decided to have DNR instructions.
The findings were published in the JAMA Internal Medicine journal on June 26.
New research from the Veteran Affairs hospitals found that disease type may dictate the quality of end-of-life care among patients.
The findings showed that there were fewer dementia and cancer patients who died in intensive care units (ICUs).
This is because many of these patients had increased end-of-life planning and comforting care, including orders not to resuscitate, compared with other dying individuals with different diseases.
In the study, "other illnesses" included frailty, heart failure, lung disease and end-stage kidney disease.
According to the study's lead researcher Dr. Melissa Wachterman, historically, end-of-life care improvements concentrated on cancer. In recent years, more efforts were made for the benefits of dementia patients.
"We really do need to expand efforts to improve care to other patients that haven't gotten that focus," added Wachterman, who is an assistant professor of medicine at Brigham and Women's Hospital and the VA Boston Healthcare System.
Wachterman highlighted that apart from cancer patients who are facing death, many patients suffering from other illnesses such as kidney disease, heart disease, lung disease and frailty are also dealing with fatal conditions.
According to the U.S. National Institutes of Health, "palliative care" is a treatment method that is focused on easing patients' symptoms as well as improving their quality of life. This type of approach is designed for patients dealing with fatal illnesses.
The palliative care approach also offers loved ones and families the support system they need to care for a fatally or seriously ill individual.
While hospice care is a similar approach, it usually begins when treatments for the illness stop. Palliative care can be done side by side with curative care.
For the study, the researchers analyzed data from 146 VA health system hospitals using medical archives and Bereaved Family Survey results. The team looked into the data of nearly 58,000 patients who died from 2009 to 2012.
They found that among patients who suffered from frailty, heart disease, lung disease and kidney disease, only 50 perceived had palliative care discussions. In comparison, more cancer patients (75 percent) and dementia patients (61 percent) received the said consultations.
"Most people don't die of cancer, but the palliative care of those dying from other diseases is not as good. But palliative care and hospice can help a lot," said Wachterman.
Nearly one-third of kidney failure, heart failure and frailty patients died in ICUs. On the other hand, only 13 percent of cancer and 9 percent of dementia patients died in ICUs.
The team also found that 94 percent of dementia and cancer patients had "Do Not Resuscitate (DNR)" orders. Among patients with other illnesses, only 87 percent decided to have DNR instructions.
The findings were published in the JAMA Internal Medicine journal on June 26.
