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End-of-life care for veterans with schizophrenia and cancer
Linda Ganzini1, Robert Socherman, Jonathan Duckart
1Mental Health Division, Portland Veterans Affairs Medical Center (VAMC), R&D 66, Portland, OR 97207, USA. linda.ganzini@va.gov
Objective:
This study compared the quality of end-of-life care between veterans with and without schizophrenia who died of cancer in the northwestern United States.
Methods:
In this cross-sectional study, medical records of 60 veterans with schizophrenia and 196 with no major mental illness who died of cancer were compared on hospice enrollment, palliative and life-sustaining interventions, advance directives, and site of death.
Results:
Among veterans with schizophrenia, 58% had an advance directive, 73% received an opiate before hospice enrollment, 63% had a physician order to forgo cardiopulmonary resuscitation, 55% were hospice enrolled, and 27% died in the hospital. Schizophrenia patients had longer hospice stays (107+/-144 versus 63+/-96 days, p=.05) and more physician orders for life-sustaining treatment (15% versus 5%, p=.006) compared with veterans without mental illness.
Conclusions:
On most measures, veterans with schizophrenia who died of cancer received comparable or better end-of-life care than veterans without mental illness.
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