Research has shown most frail elderly patients want to maintain quality of life rather than prolong it, but the use of invasive life-sustaining technologies in this population has been increasing.
A new $2.7 million national study is aiming to narrow the gap between the care that frail elderly Canadians want and the care that they receive by evaluating ways to improve care planning conversations between patients, families and health professionals.
"Canadians, especially the frail elderly, should be receiving person-centred care that is based on their goals and values," says Dr. John You, an associate professor of medicine at the Michael G. DeGroote School of Medicine at McMaster University and an internist at Hamilton Health Sciences.
"Unfortunately this is not the current reality. Many are receiving unwanted treatments that can have a negative impact on them and their families."
He added that earlier research has shown that prescribed orders for life-sustaining treatments only matched seriously ill hospitalized patients' preferences 30 percent of the time.
You is the project lead of the research project that will engage the elderly, families, clinicians, and health care organizations to implement and evaluate a suite of tools to support advance care planning, a process for reflecting on and communicating wishes for future health care. These tools include videos, workbooks, interactive websites, and conversation guides, all of which can support better communication and decision-making about care, particularly for those who can no longer communicate their wishes.
The Improving Advance Care Planning for Frail Elderly Canadians (iCAN-ACP) study is being conducted in several health settings across Canada, bringing together a team of 32 investigators from 16 universities, five international collaborators and 42 partner organizations.
Two of the co-principal investigators are also based at McMaster University: Sharon Kaasalainen, an associate professor of the School of Nursing, and Michelle Howard, a researcher in the Department of Family Medicine.
The study will be undertaken within hospital, primary care and long-term care settings.
The three-year study is funded by the by Canadian Frailty Network and supported by Government of Canada through Networks of Centres of Excellence program.
You is talking about the issue at the International Society of Advance Care Planning and End of Life Care conference, being held this week (September 6-9) in Banff, Alberta.
You says that advance care planning is a critical component of health care for this vulnerable group. "Advance care planning can have a significant impact on the patient experience and the family experience," he says. "They deserve to have their voices heard."