Oregon's Terminally Ill Patients More Likely to Have End-Of-Life Choices Respected, Study Finds

(Portland, Ore.) -- Terminally ill patients in Oregon are more likely than patients elsewhere to have their end-of-life wishes respected, and family survivors report a high degree of satisfaction with the care of their loved ones, according to new research published in the April 20 edition of the Annals of Internal Medicine.

Oregon's rate of deaths inside the hospital is the lowest in the nation. In 1996 more than two-thirds of deaths in Oregon occurred outside of hospitals. Roughly one-third of Oregonians died at home and another third died in a nursing home.

The Annals study explored what determines location of death and evaluated families' views of the end-of-life care provided to their deceased relatives. Researchers from Oregon Health Sciences University concluded that a high percentage of terminally ill patients had written advance directives, that these directives often helped avoid the use of life-prolonging hospital care and that in most cases, the wishes expressed in these directives were respected.

"Patients are making their wishes clear," said Susan Tolle, M.D., professor of medicine and director of the OHSU's Center for Ethics in Health Care. "They are saying ahead of time that they don't want to die in a hospital, dependent on life support."

The OHSU research covers two separate studies. The first evaluated the effectiveness of the Physician Orders for Life Sustaining Treatment (POLST) form. The bright-pink form records a dying patient's decision to have or limit life-sustaining treatment; it is signed by the patient's physician and meant to follow the patient from a home or nursing home through transport by ambulance to the hospital. The second study, Barriers to Improving Care of the Dying, covers a wide range of issues from the frequency of advance planning to whether terminally ill patients died in the location they preferred.

The POLST study, a statewide survey of nursing home residents, found nine out of ten had

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Oregon Health & Science University

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