It can be tough for doctors to talk to their patients about life expectancy and, as it turns out, it’s a discussion patients like to avoid as well.
A study published in the Annals of Family Medicine found the majority of older adults did not want to discuss life expectancy when presented with a hypothetical patient with a serious illness.
“Many also did not want to be offered discussion, raising a dilemma for how clinicians may identify patients’ preferences regarding this sensitive topic,” the researchers concluded.
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In the national survey, researchers asked over 800 adults, 65 or older, about a hypothetical patient with limited life expectancy but who was not imminently dying. They were asked if they were that patient what they would prefer. The results:
- 59.4% did not want to discuss with the doctor how long they might live in the presented scenario
- 59.9% did not think that the doctor should offer the discussion
- 87.7% also did not want the doctor to discuss life expectancy with family or friends
- 55.8% wanted to discuss life expectancy only if it were less than two years
The researchers found that the longer the hypothetical patient was expected to live, the smaller the number of survey participants who wanted to discuss life expectancy, but many did not want to have the discussion even when the patient had a month to live.
The research revealed patient characteristics that can help doctors determine when a patient might be receptive to such a discussion, the lead author, Nancy L. Schoenborn, M.D., of the Johns Hopkins University School of Medicine told the American Academy of Family Physicians.
"We found that patients who'd had what they considered a life-threatening illness, those who think doctors can predict life expectancy and those who have discussed the life expectancy of a loved one are much more likely to be open to these discussions," she said.
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Hearing a patient talk about being a caregiver for another family member or a recent death in their family can provide a starting point for doctors to begin a discussion about a patient’s preferences, she said.
Talking to a dying patient can be a particularly tough conversation for most doctors, which is why they can benefit from training to help teach them how to talk to patients about the sensitive topic.