End-Of-Life Abandonment?

End-of-life health care may be associated with feelings of abandonment, according to an article published in the Archives of Internal Medicine. University of Washington scientists conducted surveys and interviews with patients, family members, caregivers, nurses, and physicians regarding patients likely to die within 12 months, based on their physicians’ assessments.

Interviews were done at enrollment, 4-6 months later, and at 12 months. Questions covered included ‘looking forward’ topics, and spontaneous replies here were incorporated as ‘abandonment’. Before death, abandonment worries were concerned with a loss of contact and continuity between patient and doctor. At the time of death and later, feelings of such abandonment were recorded by families. Doctors reported ‘lack of closure’ but didn’t record this as ‘abandonment’.

There seems to be a recognizable problem. When doctors recognize they cannot offer curative treatment to patients with a poor prognosis, there’s clearly a degree of abandonment. Physician training (or re-training) needs to address this problem, offering practical guidelines for ensuring continued communication up to the time of death, and, if necessary, afterwards.