(A recent editorial in The Journal of General Internal Medicine, by the way, argues that a do-not-resuscitate tattoo isn't actually an effective way to communicate end-of-life wishes; an advance directive or POLST – physician orders for life-sustaining treatment – works better).
For those reasons, we developed a training for GPs in using a previously developed set of identification indicators, the RADPAC [ 26], in planning and providing structured anticipatory palliative care and in communicating end-of-life issues with the patient.
Unease with losing patients also affected the doctors' ability to communicate about end-of-life issues with patients and their families.
Advance health care planning addresses the hypothetical situation in which a medical crisis leaves you unable to communicate your end-of-life care preferences and values.
This study offers preliminary patient-based evidence; patients' use their own vocabulary to directly and tacitly communicate their end-of-life domain needs through narratives.
Since its original development in Oregon in 1993, Physician Orders for Life-Sustaining Treatment (POLST) is quickly growing in popularity and prevalence as a method of communicating the end-of-life care preferences for the seriously ill and frail nationwide.
It reports data from a survey of Californians by the California HealthCare Foundation (2012) that "while 60% of people say that making sure their family is not burdened by tough decisions is 'extremely important', 56% have not communicated their end-of-life wishes".
The remainder had difficulties in identifying and communicating the end-of-life stage to patients and their families, partly because of the unpredictable nature of the disease progression.
All groups highlighted the difficulty in communicating the end-of-life phase to patients and carers, especially if high expectations for survival had been raised by colleagues.
Teaching the art of communicating at end-of-life is challenging especially when it involves patients, and teachers want to ensure students gain as much as possible from the experience.
If health care providers develop knowledge and skills with respect to communicating about end-of-life care and advance care planning, individuals' wishes may be more accessible to guide care.
