Report: Watching videos of the end of life helps people make care choices

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When making decisions about end-of-life care, it helps to actually "see" what that stage of life looks like, according to a new report.

When a group of healthy seniors listened to an oral presentation on the effects of dementia in old age  and saw a video on advanced dementia, they were more likely to choose an end-of-life option of comfort/palliative care than a group that only heard the oral presentation. The findings suggest that video, in addition to discussions and spoken information, can help seniors facing dementia better understand the impact of their end-of-life decisions.

Researchers at Massachusetts General Hospital in Boston conducted the study. They divided a group 200 healthy seniors aged 65 and older into two groups: those who listened to  an oral presentation on the effects of dementia in old age and those who listened to the presentation and viewed a presentation of advanced dementia. After the presentations were complete, participants were asked to choose among three end-of-care options: care to prolong life at all costs, limited care to maintain physical function or comfort/palliative care.

A total of 86% of seniors in the video group said they would choose the comfort/palliative care option if diagnosed with dementia. That compared to 64% of those who only heard the presentation. More people in the listening group preferred the end-of-life care options of maintaining physical function, and receiving care to prolong life at all costs, compared to the other group. After a six-week follow-up, more of the oral presentation group had changed their mind about their choice of end-of-life care than the video group, according to the report.

The full report appears in the May 28 online version of BMJ at www.bmj.com.

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