Many people are in need of care in the last phase of life. However, the care they receive is not always appropriate.
One study aimed to identify what care patients - suffering from different conditions - and relatives perceive as appropriate and as inappropriate in the last phase of life, reports that they for patients described more cases of appropriate care than inappropriate care. The cases of appropriate
care were diverse, but all involved care in (one or more of) five dimensions; supportive care, treatment decisions, location, the role of the patient’s wish and communication. Each of these dimensions was frequently described (39-62 %). When care was inappropriate
, this mostly involved inappropriate treatment decisions (69 %; especially overtreatment was frequently mentioned), and poor communication (50 %). There was considerable consistency in what was seen as (in)appropriate care across different conditions - still, patients suffering from other physical diseases than cancer more often received inappropriate care.
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 which can change over time, it is necessary to repeatedly discuss the patient’s needs concerning each of the identified dimensions. What is appropriate for one patient, may be inappropriate for the other.
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.