Terminally ill often feel abandoned by doctors

March 10th, 2009 - 3:39 pm ICT by IANS  

Washington, March 10 (IANS) Terminally ill patients and their family caregivers often feel abandoned by doctors, according to a new study among cancer patients.
The results identified two themes. The first was abandonment worries related to the loss of communication between patient and physician before death.

The second was at the time of death or later, the patient’s family’s feelings of abandonment from a lack of communication by the physician.

“Doctors often don’t realise how important this issue is for patients and their families,” said study co-author Anthony Back, an expert on patient-physician communication. “Something as simple as a phone call can go a long way toward allaying abandonment concerns.”

The study found that physicians also reported a lack of closure when patients died but they did not associate this with abandonment.

“At first glance, continuity and closure may seem mutually exclusive but these elements reflect different needs occurring at different times in the dying process,” the authors wrote.

“Early on, patients and family caregivers fear that their physicians, whose expertise and caring they have come to depend on, will become unavailable.”

Near death or afterward, the patient’s family may experience a lack of closure with their physician. Physicians also report similar feelings.

“Most physicians are not consciously aware of having abandoned their patients. Instead, they report a lack of closure or a feeling of unfinished business,” Back said.

The paper contains many direct quotes from patient and physician participants who were asked to answer a series of questions about their perceptions and needs about continuity and closure.

Back and colleagues at the University of Washington School of Medicine lay out a simple plan for how physicians and nurses can achieve continuity and closure before and after a patient dies, said a Fred Hutchinson Cancer Research Centre statement.

Before death, continuity can be achieved by assuring patients that they will be available to see them and by maintaining contact, often by phone, as death approaches. Closure can be addressed by anticipating and acknowledging the probable last visit with a patient.

These findings were published in the Archives of Internal Medicine.

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