Patients Facing Death Also Face Feeling Abandoned by Doctors

Dying is not a science and for the terminally ill, coping with the stress of day-to-day survival is no easy task. Once treatments are no longer an option and an illness is deemed terminal, continued care centers upon keeping a patient comfortable until death. Although these patients appreciate company and comfort, the fact remains that we know little about having to face death, and many times patients feel abandoned by their doctors. New research has revealed that continuing care is helpful not only to the dying and their families in providing a sense of closure, but for their doctors as well. Results of the study were published in the Archives of Internal Medicine.

According to lead author Dr. Anthony Back, a professor in the department of medicine at the Fred Hutchinson Cancer Research Center in Seattle, “The therapeutic part of the doctor-patient relationship extends to the end-of-life, and it's even more important then to honor that relationship.” Although expert guidelines stress the importance of end-of-life care to ensure that patients don't feel abandoned, there has been little research into how this theory is actually put into practice.

Dr. Back explained that many times doctors end all contact with patients after referring them to hospice care, which leaves patients and their families feeling abandoned. It is his belief that patients should expect more since it makes the whole process harder when they never hear from their doctor again. In addition, he noted that family caregivers usually feel as close to the doctor as the patient does.

Dr. Back and his colleagues employed the help of 31 physicians to specify terminally ill patients with a life expectancy of less than one year. In all, 55 patients who suffered from either terminal carcinoma or advanced chronic obstructive pulmonary disease were identified for the analysis. To begin the study, each of these patients was interviewed, along with doctors, nurses, and caregivers. Follow-up interviews were conducted after four to six months, and again at the end of one year.

Regarding the results, Dr. Back said, “A number of patients and families did feel that they were abandoned by their doctor.” He went on to explain, “I'm not sure that the doctors realized they felt this way. Doctors felt a lack of closure with these patients, but felt it was something that just affected them. They weren't sure how additional contact would help.”

Dr. Back acknowledged that in addition to being under time constraints, the majority of doctors are not educated to deal with end-of-life issues. However, he noted, “even though the medical care system doesn't reward doctors for this type of care, many times when doctors do make these kinds of contacts, they find them very rewarding.” He also pointed out, “Even just a phone call or two to check in is tremendously important to the family to let them know you're still paying attention.”

Two additional studies published in the Archives of Internal Medicine addressed of end-of-life care issues. First, a research group from Boston’s Dana-Farber Cancer Institute discovered that people who suffered from advanced cancer who were given the opportunity to speak with their doctors regarding their expectations of end-of-life care experienced a higher quality of death. In addition, the cost of end-of-life care for these patients averaged about $1,000 less per person.

Boston University researchers conducted the second study in which they examined the cost differences of end-of-life care for various racial groups. The results revealed that during the last six months of life, average health-care costs for whites was $20,166, while the average cost for blacks was $26,704, and the total for Hispanics was $31,702. The use of more life-sustaining interventions for blacks and Hispanics was deemed the major reason for the disparity.

By www.healthnews.com