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BMC Geriatrics
Published in: BMC Geriatrics 1/2021

01-12-2021 | Care | Research

Concerns and potential improvements in end-of-life care from the perspectives of older patients and informal caregivers: a scoping review

Authors: Mina Motamedi, Caitlin Brandenburg, Mina Bakhit, Zoe A. Michaleff, Loai Albarqouni, Justin Clark, Meidelynn Ooi, Danial Bahudin, Danielle Ní Chróinín, Magnolia Cardona

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

Overtreatment in advanced age i.e. aggressive interventions that do not improve survival and are potentially harmful, can impair quality of care near the end of life (EOL). As healthcare provider perspectives on care quality may differ from that of service users, the aim of this study was to explore the views of older patients near EOL or their caregivers about the quality of health care at the EOL based on their lived experience, and to identify healthcare service improvements.

Methods

Medline and backward citation searches were conducted for qualitative or quantitative studies reported on the views of patients and/or informal caregivers about EOL care quality. Thematic analysis was used to summarise qualitative data (primary analysis); narrative and tabulations were used to summarise quantitative data (secondary analysis).

Results

Thirty articles met the inclusion criteria. Five main qualitative themes regarding quality care emerged: (1) Effective communication between clinicians and patients/caregivers; (2) Healthcare that values patient preferences and shared decision making; (3) Models of care that support quality of life and death with dignity; (4) Healthcare services that meet patient expectations; and (5) Support for informal caregivers in dealing with EOL challenges. The quantitative articles supported various aspects of the thematic framework.

Conclusion

The findings of this study show that many of the issues highlighted by patients or bereaved relatives have persisted over the past two decades. There is an urgent need for comprehensive evaluation of care across the healthcare system and targeted redesign of existing EOL care pathways to ensure that care aligns with what patients and informal caregivers consider high-quality patient-centred care at the EOL.
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Metadata
Title
Concerns and potential improvements in end-of-life care from the perspectives of older patients and informal caregivers: a scoping review
Authors
Mina Motamedi
Caitlin Brandenburg
Mina Bakhit
Zoe A. Michaleff
Loai Albarqouni
Justin Clark
Meidelynn Ooi
Danial Bahudin
Danielle Ní Chróinín
Magnolia Cardona
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Care
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02680-2

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