Many people are in need of care in the last phase of life. However, the care they receive is not always appropriate.
One study, led by Eva Elizabeth Bolt, designed a survey that aimed "to identify what patients and relatives perceive as appropriate and as inappropriate in the last phase of life, for patients suffering from different conditions."
Participants described more cases of appropriate care than inappropriate care. All cases of appropriate
care involved in one or more of five aspects: supportive care, treatment decisions, location, the role of the patient’s wish, and communication. Each of these aspects was frequently described (39-62%).
care mainly involved inappropriate treatment decisions (69%), especially over-treatment, which was frequently mentioned; and poor communication (50%).
While there was considerable consistency in both appropriate and inappropriate care described across different conditions, noncancer patients received inappropriate care more often.
The study conclusion is, "From the perspective of patients and relatives, appropriate care in the last phase of life is a broad concept. Caregivers should be aware of the diversity of care needs in the last phase of life. Especially treatment decisions and communication can be improved."
Because every patient has different needs that can change over time, it is necessary to repeatedly discuss each patient’s needs from each of the aspects identified. What is appropriate for one patient, may be inappropriate for another.
See reference for more information.
Adapted from Bolt EE et al. Appropriate and inappropriate care in the last phase of life: an explorative study among patients and relatives. BMC Health Services Research (2016) 16:655. Internet. Accessed on January 11, 2020.