January 31st, 2013 at 10:00 am
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Videos educate patients about end-of-life decisions

by Dorian Martin

We’ve become a society that learns via video. Want to learn how to knit? There are videos for that. Want to learn physics? A quick web search can locate videos to help in that area as well. Videos may also offer a good way of educating terminally ill patients about their choices regarding end-of-life care, as shown in a study posted on the National Cancer Institute website.

Different types of care at end-of-life

The type of care that may be provided during this period could include:

  1. Life-prolonging care, such as ventilators that help a person breathe or cardiopulmonary resuscitation (CPR)
  2. Basic medical care, such as receiving medications that fight infections
  3. Comfort care, which tries to help the patient remain free of pain and relieves symptoms but does not usually include life-prolonging treatments or medications for treatable conditions

Many people who have cancer haven’t completed advanced care planning documents that describe what type of care they wish to receive at the end of their lives, which makes this study important, even if it was small in scale. Study participants who watched a video about different kinds of end-of-life care reported having increased knowledge of these medical interventions and were less likely to choose life-prolonging care.

A picture is worth a thousand words

Video can give patients an accurate picture of the clinical reality of end-of-life interventions, said Dr. Angelo Volandes, an internal medicine physician at Massachusetts General Hospital and the study’s lead researcher. “We want to move beyond just having our patients tell us what they want: we want to make sure that they have all the information required to make an informed decision.”

This study involved 50 people who had a malignant brain tumor who were between the ages of 32 and 77. About half of the participants received a verbal explanation describing end-of-life care as well as the limitations of specific types of care. For example, they learned that CPR is not usually effective for people with advanced cancer. They also learned that comfort care usually does not include readmission to a hospital.

The other group of participants heard the same verbal narrative and also watched a short video that paired the same narrative with visual images of the care that was being described. Afterward, all of the patients were asked for their choice of the type of end-of-life care they wanted, their willingness to undergo CPR, their understanding of the different types of care, as well as their comfort with the video experience.

Videos can alter decisions about end-of-life care

Watching the video made a difference in patients’ choices regarding end-of-life care. For instance, seven people in the verbal narrative group preferred life-prolonging care after listening to the explanation. In comparison, no one in the video group opted for this type of care.

So if your elder is reaching the point where end-of-life interventions are going to be discussed, ask the doctor if access can be provided to a video about these types of interventions. By watching a video, seniors could get a better understanding of the choices being made and, thus, make a more informed decision.

For more thoughts on this, take a look at my blog post, End-of-life conversations about a good death. In another article, Shannon Dauphin asks a related question: Do you really need an advance health directive?

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