Making Final Days the Best They Can Be

None of us wants to think about facing end-of-life issues for ourselves or those we love. Yet anyone who has been at the bedside of a cherished family member or friend when treatments for cancer are no longer possible knows that making the final days the best they can be is of paramount importance. Now a study published in the July 9th online issue of Archives of Internal Medicine,a JAMA Network publication, reveals ways that we can do exactly that. A release from the journal says, "Better quality of life at the end of life for patients with advanced cancer was associated with avoiding hospitalizations and the intensive care unit, worrying less, praying or meditating, being visited by a pastor in a hospital or clinic, and having a therapeutic alliance with their physician."  The researchers, led by Baohui Zhang, M.S. formerly of the Dana-Farber Cancer Institute in Boston, wrote. “The aim of this study was to identify the best set of predictors of quality of life of patients in their final week of life. By doing so, we identify promising targets for health care interventions to improve quality of life of dying patients.”   The study included 396 patients with advanced cancer and their caregivers as part of the Coping with Cancer study. The average age of patients was almost 59 years.

“Attempts to avoid costly hospitalizations and to encourage transfer of hospitalized patients to home or hospice might improve patient quality of life at the end of life,” the authors noted. “By reducing patient worry, encouraging contemplation, integrating pastoral care within medical care, fostering a therapeutic alliance between patient and physician that enables patients to feel dignified, and preventing unnecessary hospitalizations and receipt of life-prolonging care, physicians can enable their patients to live their last days with the highest possible level of comfort and care.”

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