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Prior discussion of end-of-life measures shortened decision time for caregivers of critically ill patients
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Family caregivers who did not discuss measures of life support with critically ill patients took almost 2 weeks longer to make decisions about ending medical intervention than caregivers who had previous discussions about the issue, according to researchers from the University of Pittsburgh School of Medicine and the Graduate School of Public Health.
Also, caregivers and family members were more confident about acting as decision-makers when their communication with the intensive care physicians was perceived to be high quality, according to the researchers’ presentation at the Society of Critical Care Medicine’s annual meeting in San Diego.
“This is the first evidence to suggest that how a doctor guides family members through the foreign territory of critical illness may influence their ability to act as a surrogate,” study investigator Douglas B. White, MD, associate professor and director of the Program on Ethics and Decision-Making in Critical Illness in the department of critical care medicine, said in a press release. “Teaching doctors to be better communicators may be an important step in improving end-of-life decisions for patients.”
The researchers conducted the study at four ICUs at the University of California-San Francisco Medical Center from 2005 to 2008. They surveyed 230 caregivers who had the responsibility of making medical decisions on behalf of a patient. The patients were on ventilators and had more than a 50% chance of dying. They found that caregivers who did not have any previous conversation with the patient were less confident and took 33 days to decide to end life support vs. 21 days for those who had previous discussions about life support.
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