A recent investigation has proven that palliative care is often offered to patients suffering from cancer or dementia, but other patients with life-threatening diseases can not often benefit from this type of attention. The investigation hopes to bring more attention to the matter.
The research aimed to understand how patients with different illnesses were treated in their end-of-life care and how their families would grade the treatment, showing that depending on the patient’s disease or race the type of treatment changed.
Families with cancer or dementia patients appeared to be more satisfied with palliative care. They received more consultations and gave more attention to end-of-life care compared with relatives of patients with organ failures and several other life-threatening diseases. The research also showed that these patients had more do-not-resuscitate orders.
“A lot of the focus of end-of-life care is on cancer, but most people don’t die of cancer. Our findings show that the quality of end-of-life care for other illnesses is not as good,” said Dr. Melissa Wachterman, lead author of the research.
Surveying family members
The investigation was published in the Journal of the American Medical Association Internal Medicine on June 26th, and it was presented at the Academyhealth Annual Research meeting on the same day.
The research team studied 58,000 cases of diseased patients between 2009 and 2012 belonging to the Veterans Health Administration system and surveyed most of the patient’s families to understand their experiences with palliative care.
Family members were asked to explain their experiences and rate the palliative care the patient received as well as their satisfaction with the treatment and if it reached their expectations. Investigators tried to understand the end of life care the sick patient received.
75 percent of cancer patients and 61 percent of dementia patients received palliative cares, and consultations for do not resuscitate orders from physicians. Meanwhile only half of the 58,000 patient, which all had organ failure, received palliative cares and end-of -life consultations.
Also, the study showed that one-third of organ failure patients died in the Intensive Care Unit. Meanwhile, only 13 percent of cancer and dementia patients died in intensive cares.
After asking family members to rate the type of treatment the patient received, 60 percent of the families with cancer and dementia patients assured they received an excellent treatment.Family members of patients with organ failure rated the treatment in a similar way to cancer and dementia family members. Yet the end-of-life consultations were not the same.
“This paper shows that we have made progress for patients with cancer and dementia, for example, fewer ICU visits, but there is a way to got for other prevalent medical conditions, like end-stage heart, lung or kidney disease,” assured Dr. Justin Bekelman to CNN News, who is an oncologist from Pennsylvania, who wasn’t involved in the study.
A research also shown in the Academy Health annual research, showed racial disparities in the American health care system. It found that black veterans and latinos were less likely to receive spiritual care when compared to white patients.
Palliative and Hospice care
Physicians and patients commonly confuse palliative care with hospice care, and if not, patients and family members have to choose between both of them. According to the Centers for Disease Control and Prevention (CDC), there are 4,000 hospice care agencies in the country and 1.3 million patients that benefit from the service.
Palliative care is known as a multidisciplinary approach from physicians for patients with life-threatening diseases. This type of care focuses on giving patients different ways to relieve symptoms from their diseases, despite the diagnosis.
When offering palliative care, physicians also orientate family members in the treatment and journey of the patient. They also explain the treatment and the different ways the patient could be more comfortable.
This type of care is often offered by nurses and health professionals that work along with the main physician of the patient. The care is distributed by different physicians in their prevalent areas of specialization.
Hospice care specializes more in the spiritual and emotional area of patients with life-threatening diseases and guiding their family members. It is more common in patients without a cure for their deadly disease in their final stages.
Physicians assure both care systems must be done simultaneously, to both the patient and their family members to have a better understanding and acceptance of the disease. With the investigation, researchers hope to broaden the horizons of this type of care to all patients facing life-threatening diseases.
With this investigation, researchers hope to broaden the horizons of this type of care to all patients facing life-threatening diseases. Education to both patients and families is also an objective, that will allow better treatments for patients with deadly diseases.
Source: JAMA