End-of-life care at odds with patient wishes

Highlighting the need for better physician-patient communication, most end-of-life wishes for Californians differ from what actually occurs, according to a California HealthCare Foundation (CHCF) survey conducted in late 2011.

Almost 80 percent of respondents said they want to talk with their doctor about end-of-life care, yet only 7 percent have had that discussion. Moreover, 82 percent said it's important to put end-of-life wishes in writing, while only 23 percent have done so, according to the survey released this week.

The findings also revealed that the majority of patients (84 percent of Democrats and 72 percent of Republicans) support paying doctors to talk about end-of-life options, reported the San Francisco Chronicle. "This seems to be a red-hot partisan issue," CHCF President and CEO Mark Smith told the Chronicle. "But when you actually talk to people - doctors, patients, politicians - on the ground, there's really remarkable consensus."

According to the survey, although 70 percent of Californians would rather die at home, only 32 percent have made those arrangements, with 42 percent dying in a hospital and 18 percent in a nursing home.

In another push for end-of-life physician-patient communication, a study published last summer in the Journal of Hospital Medicine showed that discussing end-of-life care with patients doesn't lead to increased mortality. Contrary to common concerns, researchers found that having advance directive talks didn't increase or decrease a patient's risk of death.

For more:
- read the San Francisco Chronicle article
- check out the CHCF survey

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