Honest Communication with Seriously ill Patients

It is not easy to tell patients they are going to die.  Despite the fact that chemotherapy delivered to cancer patients with a poor prognosis is intended only to provide palliation, not a cure, a majority of patients with metastatic cancer have false expectations regarding the curative potential of the treatment.

This raises the question of whether the needed patient-physician conversations about palliative and end-of-life care are even taking place.  Patients who do not know whether a treatment offers any possibility of cure may be compromised in their ability to make informed treatment decisions that are consonant with their preferences.  This misunderstanding could represent an obstacle to optimal end- of-life planning and care.

If patients have unrealistic expectations of a cure from a therapy that is administered with palliative intent, there is a serious miscommunication that needs to be addressed.  Studies have shown that two-thirds of doctors tell patients at the initial visit that they have an incurable disease, but only about a third actually state the prognosis.   It is not easy to tell patients that they are going to die and many physicians choose not to do this.  It might explain why two months before death, many patients with cancer have not heard any of their doctors use the word "Hospice."

Most patients want to know whether or not they can be cured, and physicians can provide them with the information they need in order to plan for their remaining life.  If patients are offered truthful information on what is going to happen to them, they can choose wisely and physicians can help them make these difficult decisions. 

Helping seriously ill patients and their families to become proactive in understanding and seeking the services of palliative medicine and Hospice care is the focus of a new educational campaign from The Joint Commission. "Speak Up: What You Need to Know about Your Serious Illness and Palliative Care," the program offers free downloadable brochures, videos and posters.  Topics addressed in the brochure include how and when to get palliative care, questions palliative care specialists may ask patients, questions for patients to ask their palliative care providers and where to get more information.  www.jointcommission.org/topics/speakup_brochures.aspx

The Villas in Antioch, Martinez and Alamo work together with families, residents, physicians and Hospice or Palliative care agencies to insure there is clear and honest communication with patients living with serious illnesses.  We are proud to assist guiding residents and their families through one of life's most challenging times with clinical expertise and compassion.  Please contact us if we can assist you with placement of a loved one, or just information regarding eldercare services.
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Vitamin D deficiency ages bones

A recent study conducted by American and German scientists found that vitamin D deficiency not only inhibits the formation of new bone but also accelerates aging of existing bone, according to an article in Medical News Today. The study appears in the journal Science Translational Medicine.
Robert Ritchie, leader of the American team from the University of California, Berkeley, said, “The assumption has been that the main problem with vitamin D deficiency is reduced mineralization for the creation of new bone mass, but we’ve shown that low levels of vitamin D also induce premature aging of existing bone.”
Vitamin D helps the body absorb calcium. When a person becomes vitamin D deficient, his or her body takes calcium from the bone to replenish blood calcium levels, which can lead to rickets (in children), osteomalacia, or osteoporosis. According to Björn Busse, leader of the German team and a scientist at the University Medical Center in Hamburg, “Unraveling the complexity of human bone structure may provide some insight into more effective ways to prevent or treat fractures in patients with vitamin D deficiency.”
The study highlights the importance of continually monitoring and maintaining vitamin D levels in patients who are at risk for vitamin D deficiency. The article suggests that vitamin D deficiency is a growing problem in the United States.
It is not too late to start adding vitamin D to your daily regimen. Patients 65 and older stand to benefit from everyday vitamin D supplementation. In 2012, the U.S. Preventive Services Task Force suggested that supplemental vitamin D combined with exercise can reduce the risk of falls in individuals who are at an increased risk. To reap the benefits, it is crucial that patients take a high enough dose as determined by a physician. The American Geriatrics Society recommends that patients with proven vitamin D deficiency take at least 800 IUs a day.

Please visit us at VillaCareHomes.com   We care about the physical, social, mental and emotional needs of our residents.