How to help your patients die well
All health professions aim to provide the best care they can for their patient. However, achieving this is easier said than done. In this issue of the Journal, Horey and colleagues document the implementation of a care pathway aimed at facilitating care at the end of life (EOL) in 14 residential aged care facilities (RACFs),1 while Thompson and Brown’s letter raises the problem of resuscitation often being the default position when elderly patients deteriorate rapidly, even though the survival rate is poor and most older people do not want that option.2
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- 1. Horey DE, Street AF, Sands AF. Acceptability and feasibility of end-of-life care pathways in Australian residential aged care facilities. Med J Aust 2012; 197: 106-109.
- 2. Thompson CH, Brown M. Should resuscitation replace good communication in the care of elderly patients? Med J Aust 2012; 197: 89.
- 3. Gill TM, Gahbauer EA, Han L, Allore HG. Trajectories of disability in the last year of life. N Engl J Med 2010; 362: 1173-1180.
- 4. Seymour JE, French J, Richardson E. Dying matters: let’s talk about it. BMJ 2010; 341: c4860.
- 5. Hillman K. Vital signs: stories from intensive care. Sydney: UNSW Press, 2009.
- 6. Ashby M. The futility of futility: death causation is the “elephant in the room in discussions about limitation of medical treatment. J Bioeth Inq 2011; 8: 151-154.
- 7. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 2010; 340: c1345.
- 8. Ellershaw J, Smith C, Overill S, et al. Care of the dying: setting standards for symptom control in the last 48 hours of life. J Pain Symptom Manage 2001; 21: 12-17.
- 9. Murray SA, Sheikh A. Care for all at the end of life. BMJ 2008; 336: 958-959.
- 10. Rogers E. Diffusion of innovations. New York: Free Press, 1983.
- 11. Economist Intelligence Unit. The quality of death: ranking end-of-life care across the world. London: The Economist, 2010.
- 12. Seymour JE. Looking back, looking forward: the evolution of palliative and end of life care in England. Mortality 2012; 17: 1-17.
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