The Importance of a Comprehensive, Patient-Centered Approach to End-of-Life Care

Excerpt

Relieving suffering of the dying patient is a core mission not only of palliative care providers, but of every clinician who participates in the care of seriously ill patients. Too often, patients and families suffer unnecessarily at the end of life because dying is not recognized, providers do not communicate about prognosis, and symptom management is inadequate. Several studies have documented unmet needs related to communication and symptom management for patients who die in the hospital in the United States.1,2 This problem is multi-factorial. Despite the fact that early advance care planning discussions are associated with better patient and caregiver outcomes,3,4 studies suggest that these discussions are often delayed5 and quality measures in this domain are often not met.6,7 There is, instead, a tendency to focus on disease-focused rather than patient-centered treatments, which often leads to patients receiving care inconsistent with preferences or prognosis. …