The deafening silence surrounding end-of-life care

Californians are not having important discussions about end-of-life preferences with doctors and loved-ones, even though they would like to.

A poll conducted by the California Healthcare Foundation (CHFC) shows that a large majority of respondents would either ‘definitely’ (47%) or ‘probably’ (32%) like to speak to a doctor about their wishes for medical treatment at the end of their life, but a staggering 92% had never had this conversation.

The survey, entitled ‘Final Chapter: Californians’ Attitudes and Experiences with Death and Dying’, saw a representative sample of 1669 people asked about their opinions on end-of-life care, with some interesting findings.

The three most important factors relating to end of life care, according to the majority of respondents, were making sure that family were not financially burdened, being comfortable and without pain and being at peace spiritually.

Another question assessed how familiar respondents were with end-of-life terms. The results are shown in the figure below (source: California Healthcare Foundation), with only 17% of people saying that they had heard of palliative care and just 13% familiar with POLST (physician orders for life-saving treatment).

Source: Californians’ Attitudes Toward End-of-Life Issues, Lake Research Partners, 2011. Statewide survey of 1,669 adult Californians, including 393 respondents who have lost a loved one in the past 12 months

Furthermore, there was a large discrepancy between respondents’ desired place of death and the actual place of death of people who died in the state in 2009 (a frequently recurring theme in end-of-life care surveys throughout the world).  Whilst 70% of people surveyed said that they’d prefer to die at home, only 32% of deaths in California occurred at home in 2009.

Read the full report here.

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