Families of patients who receive aggressive end-of-life medical care do not perceive the care as high-quality, according to research published online ahead of print January 19 in JAMA.
Lead author Alexi A. Wright, MD, MPH, interviewed 1,146 family members of patients with advanced-stage lung or colorectal cancer (median age, 76 years; male, 55.8%) who died in 2011. When patients received hospice care for longer than 3 days (58.8%), family members reported excellent end-of-life care more often, compared with family of patients who did not receive hospice care or received it for 3 or fewer days (43.1%). Family members of patients who did not receive hospice care or received 3 or fewer days were less likely to report that patients died in their preferred location (40%) than the family of those who received hospice care for longer than 3 days (72.8%). For patients admitted to an intensive care unit (ICU) within 30 days of death, family members reported excellent end-of-life care less often (45%), when compared with the family of patients who were not admitted to an ICU within 30 days of death (52.3%). Family members of patients who died in the hospital were less likely to report excellent end-of-life care (42.2%) than those of patients who did not die in the hospital (57.4%).
“Our study findings are a powerful argument for the importance of advance care planning,” Dr. Wright said. “The more information patients have, the more likely they are to receive the kind of medical care they want near death.”