Recently an NPR story http://www.npr.org * noted: “Of the 5 million Americans with failing hearts, about half of them will die within five years of getting diagnosed. Given the odds, it seems that people with heart failure should start thinking about how they want to die. But doctors don’t routinely talk to those patients about end-of-life planning.”
“When researchers asked 50 doctors and 45 nurse practitioners and physician assistants how often they discuss preparing for death with their heart failure patients. A third of the providers said they lacked confidence in talking about end-of-life care. Only 12 percent said they have routine yearly discussions about the end of life.”
“The common reasons are that they’re uncomfortable, they may not have enough time, or they sense that the patient or the family is not ready to have those discussions…,”
“End-of-life conversations…. involve asking tough questions like: Would you want a feeding tube or CPR? If you can’t breathe, would you want a tube placed down your throat to help you breathe? Are you trying to live as long as possible, or is your goal to maximize your quality of life? Do you want to die in your sleep?”
“One solution…..could be to encourage healthcare providers to have those conversations annually with patients, no matter what condition the patient is in at the moment. That’s particularly important because a patient’s attitude toward handling death can change over time, and because heart failure patients tend to overestimate how long they’ll live.”
* to read the full NPR article “Doctors Hesitate To Ask Heart Patients About End-Of-Life Plans” by Rae Ellen Bichell , highlight and click on open hyperlink http://www.npr.org/blogs/health/2014/06/04/318772558/doctors-hesitate-to-ask-heart-patients-about-end-of-life-plans?utm_campaign=KHN%3A+First+Edition&utm_source=hs_email&utm_medium=email&utm_content=13094700&_hsenc=p2ANqtz-8TR2VbAFuR82rIEWDA3azEYM_5DHYSf5n6EVS7NuRFRg-5dutYm06YRrQl0nF_Lu8WmsuDJ82GWvHsnOGTQb8dywtehI1kJV_EIJscfpAVjTMjIbo&_hsmi=13094700
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Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
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