Researchers at the University of Sheffield’s School of Nursing & Midwifery in the UK found that healthcare professionals often struggle to identify when patients are in their last 12 month of life and frequently fail to discuss prognosis with hospital patients.
This lack of communication between medical staff and patients and their families severely limits their ability to be involved in important decisions about their care and treatment.
Principal Investigator, Christine Ingleton Professor of Palliative Care Nursing at the School of Nursing and Midwifery, said: “Most people want to make choices about the care and treatment they receive at the end of life. However, our research shows that a failure on the part of health professionals to discuss prognosis and goals of care means that many are not given this opportunity. Only a small minority of patients will receive care from specialist palliative care clinicians; most will be cared for by non-specialists.”
The study highlights an urgent need to build capacity in palliative care management amongst clinicians working in the acute hospital setting. Medical staff in particular need support to help them discuss prognosis and care and treatment options at the end of life with their patients, said researchers.
A doctor, who took part in the study, described how prognosis is not routinely discussed with patients in hospitals: “We never do that. I think for a variety of reasons. It’s not because we don’t want to provide information but quite often breaking bad news to a patient can be pretty difficult and we take a very different approach which may not be right but unless the patient asks for their prognosis we don’t tell them the prognosis.”
Project manager, Dr Clare Gardiner, who conducted the study at the University of Sheffield and is now based at the University of Auckland, New Zealand, added: “It’s hugely important that people at the end of their life are helped by skilled clinicians to make decisions about what happens to them. After all, we only have one opportunity to get it right.”
A report on the study, ‘Transitions to palliative care for older people in acute hospitals: a mixed-methods study’, has been published in the NIHR Journals Library.