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Communicating end-of-life preferences
Deborah Dillon McDonald1, Jo-Ann Deloge, Nicole Joslin
1University of Connecticut, School of Nursing, USA.
Western Journal of Nursing Research
|October 8, 2003
Summary
Adults often discuss end-of-life preferences vaguely, lacking the detail needed for others to honor them. Regular conversations with healthcare providers and loved ones can improve clarity and comfort.
Area of Science:
- Gerontology
- Public Health
- Communication Studies
Background:
- Effective communication of end-of-life preferences is crucial for patient-centered care.
- Previous research indicates challenges in initiating and conducting these sensitive discussions.
Purpose of the Study:
- To investigate how adults communicate their end-of-life preferences.
- To identify factors influencing the initiation of end-of-life discussions.
- To assess the clarity and methods used in communicating these preferences.
Main Methods:
- A qualitative survey involving face-to-face interviews.
- 119 community-dwelling adults who had discussed end-of-life preferences were interviewed.
- Data analysis focused on communication patterns and content.
Main Results:
- Personal illness/death experience and directness facilitated discussions.
- Vague preferences were common (e.g., "no machines," "no heroics").
- Few used living wills effectively or reinforced preferences; only 21% discussed with physicians.
Conclusions:
- Current end-of-life preference communication lacks necessary detail for accurate fulfillment.
- Facilitated and routine dialogues are needed for greater clarity.
- Enhanced communication strategies can improve care alignment with patient wishes.