Old and terminally ill people do not want end-of-life care to focus on postponing death

It is something everyone will have to deal with. Our life has its beginning and it has its ending. It is not fun being aware of that, but it is the reality. End of life typically requires some sort of care. People get sick physically and mentally and cannot take care of themselves. Now scientists from the University of New South Wales conducted a study, which showed that terminally ill, older adults would prefer to receive higher quality supportive care rather than treatments to prolong life.

Scientists interviewed 24 older adults in NSW who were either terminally ill or cared for a person faced with advanced or irreversible disease. They wanted to find out their attitudes towards end-of-life care and its goals. Summing up the information they got during these conversations scientists were able to  identify the most common themes: quality as a priority; a desire for a sense of control; living a life on hold; the need for health system support; a preference for being at home; talking about death; and dealing with competent and caring health professionals. It is clear that people are mostly concerned about the quality of the time they have remaining.

Terminally ill and old people typically prefer staying at home receiving treatment designed to improve their quality of life or reduce suffering. Usually these people are against aggressive end-of-life treatments meant to prolong their time on this Earth. In other words, they value quality over quantity and accept the reality as it is. However, despite these clear wishes and preferences, most older people from the developed world spend their last days in hospitals getting treatments from conditions that are not going to pass. The big issue is that patient’s wishes and concerns are not accurately incorporated into his treatment.

And so scientists say that guidelines should change. Governments should support end-of-life care at home and appropriate communication. Ebony Lewis, lead author of the study, said: “Urgent strategies are needed to support terminal care outside the acute hospital as well as tools to give health care professionals the ability to deliver more skilled end-of-life communication that incorporates the patients’ personal values”. Inadequate decisions at the final stages of life cause a huge deal of regret for the remaining families.

Population of the big part of the Western world is ageing. There will be more and more old people and someone will have to take care of them. It is important that everyone can feel comfortable at the end of his life and their preferences are taken into account when a therapy is selected.

Source: UNSW