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Marcy Tolkoff, JD

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January 21, 2015

In This Article

Can We Talk? Five Important Topics for Seriously Ill Patients

There are five important factors that hospitals and families must address when it comes to end-of-life discussion with patients, says a recent study published in the Canadian Medical Association Journal.[12] Researchers at McMaster University asked 233 adult patients with serious illnesses and 205 family members in nine Canadian hospitals about the occurrence and importance of 11 guidelines recommended in goal-of-care discussions. They said that the five most important elements of a discussion with seriously ill hospitalized patients and their families are:

Preferences for care in the event of life-threatening illness;

Patient values;

Prognosis of illness;

Fears or concerns; and

Additional questions regarding care.

Researchers found that the above subjects are infrequently discussed and that there is a gap between preferred and prescribed goals of care. "Our findings could be used to identify important opportunities to improve end-of-life communication and decision-making in the hospital setting," said John You, MD, lead author of the study and an associate professor of medicine and clinical epidemiology and biostatistics at McMaster's Michael G. DeGroote School of Medicine.

It's important to note that the majority of patients with advanced illness are Medicare patients and that the American Medical Association recently recommended Medicare cover end-of-life discussions, which advocates say would increase the chances that doctors would initiate these important discussions with patients.

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