Dying Patients Often Don’t Get Appropriate Care, Researchers Say
August 27, 2010 - Reports & Studies
“Patients in American hospitals receive intensive medical treatments,” that are not always the best for end-of-life situations, according to the June 28, 2010 report “The Quality of Care Provided to Hospitalized Patients at the End of Life," in the Archives of Internal Medicine. “However, when life saving treatments are unsuccessful, patients often die in the hospital with distressing symptoms while receiving burdensome care,” the report said.
The report discussed a study at Ronald Reagan UCLA Medical Center of critically ill patients who had been hospitalized for at least three days and died at the hospital. The issue is whether they received excessive care in view of their terminal condition. A third of the patients were placed on ventilators before they died and 15% died while receiving cardio-pulmonary resuscitation attempts. The system of care was better at treating pain and difficulty in breathing than in dealing with the patient and family’s wishes, the study noted. “Goals of care were addressed in a timely fashion for patients admitted to the intensive care unit approximately half of the time, whereas pain assessments (94%) and treatments for pain (95%) and dyspnea [difficulty breathing] (87%) were performed with fidelity,” the report said. It called for a new approach to identifying and carrying out the wishes of the dying. “A practical, medical chart–based assessment identified discrete deficiencies in care planning and symptom palliation that can be targeted to improve care for patients dying in the hospital.”