End of Life

It’s a difficult subject of special interest to Zoomers. What happens at the end of life? A study from Harvard medical School finds that terminally ill people who get early counseling about end-of-life care undergo less aggressive medical treatment in their final days.

The findings suggest  that patients who only discuss their wishes at the last minute end up undergoing more lifesaving efforts such as chemotherapy and intensive care. Those who discuss their wishes earlier are more likely to undergo the alternative — treatments like hospice care whose main purpose is to reduce suffering, not to extend life.

The study, said to be the first of its kind, sought to understand whether the timing of these discussions  made any difference in their care patients received as they died.

The researchers tracked 1,231 patients with terminal lung or colorectal cancer who died over a 15-month period.

Of those who only discussed end-of-life care in the final month of life, 65 percent received aggressive care in those last 30 days.

But among the patients who had that discussion  more than three months before death: Only a third received aggressive treatment in their final month.

The numbers suggest that delaying discussions of end-of-life care leads to more aggressive treatment during a patient’s final days instead of treatment that’s purely designed to ease suffering.

Does this mean that terminal patients who discuss their wishes earlier are more likely to get the treatment they desire at the end of their lives?

The researchers believe the answer is yes. They say patients who understand a poor prognosis are more likely to choose less aggressive care at the end of life. And even though not every patient opts for palliative care, most who recognize that they’re dying want that.