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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