Monday, 13 July 2015

End of life: how to avoid hospitalizations?

Many people are sent to hospital to be attended to during the clinical stage complications they suffer from in the last months of life. We are all aware that we’re not dealing with this issue very well and in addition we haven’t gone to great lengths to improve it. What do these hospitalizations bring? Could they be avoided?

Palliative Medicine magazine just published a timely survey addressed to Dutch family physicians in order to gain insights into their thoughts about hospitalizations during the end of life for their own patients. And the results are quite suggestive:

24% of Dutch family doctors believe that hospitalizations during the last three months of life could have been avoided, half of them simply by working more actively on the communication between doctor, patient and the family; and the other half, with more communication between professionals and primary hospital, more home services and more family support. Subsequently, several of the surveyed physicians were chosen for in-depth interviews, and during this phase a more careful analysis of the circumstances surrounding primary care and end stage of life of many patients, emerged. We can highlight the lack of time to sit in the patient's room, sip a cup of tea and talk sensibly about the best options to follow and even more worrying, there’s the incomprehensible ignorance in some cases of the patient’s family (or some members of it) that the end is near.

The health system is not dealing properly with the end of life medical care of elderly people. More research is needed on the adequacy of clinical practice and, above all, more scientific and social debate on the subject.

Jordi Varela


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