Study: End-of-life care planning improves quality of life of terminally ill patients

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Amid the brouhaha over advance care planning, a new study finds that such counseling actually makes dying cancer patients feel better.

The study involved 322 patients diagnosed with terminal cancer in rural New Hampshire and Vermont. Half were assigned to receive usual care. The other half received usual care plus counseling about managing symptoms, communicating with healthcare providers and finding hospice care. In the study, trained nurses did the end-of-life counseling, mostly by phone, with patients and family caregivers. Patients and their caregivers also could attend monthly 90-minute group meetings with a doctor and a nurse to ask questions and discuss problems. Patients who got the counseling scored higher on quality of life and mood measures than patients who did not.

One provision in House legislation would allow Medicare to reimburse doctors that have end-of-life discussions with patients. Opponents have accused Congress of encouraging government-sponsored euthanasia. Kathleen Sebelius, secretary of the Department of Health and Human Services, said this provision now is likely to be dropped from the bill. The study appeared in Wednesday's Journal of the American Medical Association.


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