Initiating end-of-life care discussionsCreated by:
End-of-life-care conversations are difficult to initiate. Some patients may misunderstand the intention of healthcare practitioners if they initiate this conversation once the patient is diagnosed with a terminal illness. What usually happens is, these conversations are initiated once the patient enters the advanced stages of the disease, or worse advanced directives are only sought once patient goes into cardiac arrest. In the United States, initiatives are being done to educate children regarding advanced directives and by the time that they reach 18, they can formalize their preferences for end of life care. I think this should be adapted in our local setting because this makes end of life care more efficient. I've witnessed countless times that families have disagreements over end of life care decisions for brain dead patients. This often leads to prolonged hospitalization, confusion in goals of treatment and unnecessary medical expenses.
Do you think end-of-life care discussions should be initiated earlier on? If so, when do you think it is it appropriate to discuss this issue with patients?