Featured Research

from universities, journals, and other organizations

Patients with advanced co-existing illnesses and their carers face uphill struggle

Date:
July 14, 2014
Source:
BMJ-British Medical Journal
Summary:
Patients in their last year of life with co-existing illnesses struggle to cope with a bewildering array of services and treatments, which are often poorly coordinated and lack any continuity of care, indicates an analysis of patient and carer feedback. Patients and carers frequently found accessing the support they needed "impersonal" and "challenging," the comments showed.

Patients in their last year of life with co-existing illnesses struggle to cope with a bewildering array of services and treatments, which are often poorly coordinated and lack any continuity of care, indicates an analysis of patient and carer feedback, published online in BMJ Supportive & Palliative Care.

Patients and carers frequently found accessing the support they needed "impersonal" and "challenging," the comments showed.

It's important to get this right, say the researchers, because 'multimorbidity,' in which patients are coping with several illnesses at the same time, is increasingly common in the last year of life, and associated with frequent hospital admissions.

They drew on 87 semi structured interviews with 37 patients considered to be in the last year of their life from an acute admissions unit in a Scottish regional hospital; a large general practice in England; a respiratory diseases outpatient clinic in London; and 17 family carers.

The interviews took place at 8-12 weekly intervals over a period of five to nine months, in a bid to gauge interviewees' understanding of their various conditions, and their experience of care in different services and environments.

The patients were aged between 55 and 92, and 23 of them were men. They had several illnesses, including: heart, respiratory, liver and kidney failure; lung cancer; neurological conditions; and mild dementia.

Their feedback reflected an ongoing struggle to cope with several different care systems, services, and staff.

The interviewees described complicated, confusing and, at times, unresponsive services, and the lack of coordination and continuity of care led them to perceive care as inconsistent and impersonal.

No single diagnosis and difficulty explaining their health problems made requesting surgery appointments or GP visits hard, while getting to a clinic was physically demanding for them.

Many of the patients were taking more than 10 different drugs every day, and frequent changes in medication were linked to hospital admissions, making them question the purpose and effectiveness of these changes.

Carers found themselves dealing with increasing physical and emotional demands without any idea of how long they would be required to fulfil this role.

There was little evidence of integrated care planning or any open discussion about the future among patients, family carers, or health professionals.

Patients and carers often coped by focusing on doing the best they could in the here and now, rather than thinking about death. Indeed, most patients put their failing health down to 'getting old,' rather than progressively deteriorating health. Some saw being independent and not having to ask for help or rely on services as important.

"We need a change of culture to encourage proactive care, while at the same time helping to maintain a sense of identity as a 'normal' old person," write the authors, who advocate a systematic approach to identifying patients with several advanced illnesses.

This would enable them to live well while planning for the inevitable future deterioration in their health, they suggest.

"More and more of us will face many years of living with multimorbidity: the challenge is to make those years as healthy as possible," they conclude.


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal Reference:

  1. B. Mason, V. Nanton, E. Epiphaniou, S. A. Murray, A. Donaldson, C. Shipman, B. A. Daveson, R. Harding, I. J. Higginson, D. Munday, S. Barclay, J. Dale, M. Kendall, A. Worth, K. Boyd. 'My body's falling apart.' Understanding the experiences of patients with advanced multimorbidity to improve care: serial interviews with patients and carers. BMJ Supportive & Palliative Care, 2014; DOI: 10.1136/bmjspcare-2013-000639

Cite This Page:

BMJ-British Medical Journal. "Patients with advanced co-existing illnesses and their carers face uphill struggle." ScienceDaily. ScienceDaily, 14 July 2014. <www.sciencedaily.com/releases/2014/07/140714213634.htm>.
BMJ-British Medical Journal. (2014, July 14). Patients with advanced co-existing illnesses and their carers face uphill struggle. ScienceDaily. Retrieved September 23, 2014 from www.sciencedaily.com/releases/2014/07/140714213634.htm
BMJ-British Medical Journal. "Patients with advanced co-existing illnesses and their carers face uphill struggle." ScienceDaily. www.sciencedaily.com/releases/2014/07/140714213634.htm (accessed September 23, 2014).

Share This



More Health & Medicine News

Tuesday, September 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins