Dying a good death

“More than 70 percent of us will die from a protracted, chronic illness where good planning will make a difference in the quality of our death,” says Karin Kirchhoff, a School of Nursing professor.

Using a $2 million grant from the Agency for Healthcare Research and Quality, Kirchhoff will test a new approach of preparing patients and their families for the end of life.

The approach is called “Patient-Centered Advance Care Planning.” It uses a trained facilitator to talk with and listen to patients and their surrogates (those who will make care decisions for them), explore their misconceptions about end-of-life care and death, explain the burdens and benefits of various treatments, and prepare surrogates to understand and carry out patient wishes.

Recent studies have repeatedly shown that what patients say they want and what they receive in end-of-life care often do not coincide, leading to poor communication, confusion among patients, families and caregivers, and a less peaceful death than might be possible otherwise.

The study will randomly assign end-of-life patients and their surrogates to either the new approach or usual end-of-life care planning. The project, expected to run through mid-2007, will enroll up to 560 patient/surrogate pairs.