Study Asks, What Is a 'Good Death'?
Discussions must go way beyond treatments and deal with the patient's sense of peace, experts say
By Amy Norton
WEDNESDAY, March 30, 2016 (HealthDay News) -- At the end of their lives, most people want peace, as little pain as possible, and some control over how they die, a new research review finds.
Researchers said the study gives some sense of how people typically define a "good death."
For those facing a terminal illness, it seems that what matters most is control over the dying process -- being home rather than in hospital, for instance -- being pain-free, and having their emotional and spiritual needs met.
And for their families, the hopes are largely the same, according to the review of an international array of studies on "successful dying."
The findings were published March 30 in the American Journal of Geriatric Psychiatry.
Yet, experts said, when it comes to caring for terminally ill patients, doctors often focus the discussion on treatments -- which ones are wanted, which ones are not.
"That's important, but we have to go way beyond that," said Dr. Dilip Jeste, the senior researcher on the study and director of the Stein Institute for Research on Aging at the University of California San Diego School of Medicine.
"The take-home, to me, is that we really need to talk to patients about the dying process," Jeste said.
Often, he noted, the subject is seen as "taboo," by doctors, family members and even patients themselves.
"Even if patients want to talk about it," Jeste said, "they may be afraid to bring it up with their families, because they don't want to upset them."
Because of that, Jeste said, he's found that patients often "feel relieved" when their health providers broach the subject.
It's true that "advance care planning" for people with serious illnesses often focuses on treatments, agreed Dr. R. Sean Morrison, who directs the Herzberg Palliative Care Institute at Mount Sinai Icahn School of Medicine, in New York City.
So a patient, for instance, will make decisions about whether he wants doctors to try to prolong his life by using a mechanical ventilator when he can't breathe on his own, or feeding tube when he can't eat.