Nurses could help reduce 'unnecessary' end of life treatment

Non-beneficial care at the end of life could be reduced by nurses providing more treatment information to patients and their families. 

Nurses could play a key role in reducing 'invasive and potentially harmful' treatments of older people during their last weeks of life, a leading cancer nurse said.

Analysis of data from 1.2 million patients worldwide, including those from England, found patients being subjected to 'excessive' and unescorted treatments that made no difference to the course of their illness.

The University of New South Wales study found about a third of older patients with advanced, irreversible conditions, such as incurable cancer, were given treatments that were of no benefit to them.

These included admission to ICU, resuscitation of patients with 'do not resuscitate' orders, and chemotherapy to patients in the last 14 days to one month of life.

Unrealistic expectations

Researchers said advances in medical technology had led to 'unrealistic expectations' in some cases about what healthcare professionals could achieve.

The report found:

  • 33% of cancer patients were given chemotherapy in the last six weeks of life.
  • 10% of all patients were admitted to intensive care.
  • 33% were given antibiotics, cardiovascular, digestive or endocrine medicines.
  • 30% given dialysis, radiotherapy, blood transfusions or other life support.
  • 25% of patients with 'do not resuscitate' orders in their notes were resuscitated.
Marie Curie response

Responding to the research, Marie Curie said 'damaging' film and television portrayals of medicine painted illness to be a 'heroic battle', and that talking about palliative care at an earlier stage would improve quality of life.

Marie Curie deputy director of nursing Anne Cleary said nurses were well placed to help patients and their families make informed decisions about treatments to avoid unnecessary interventions.

'We must move away from the idea that providing palliative care is giving up on a patient,' she told Nursing Standard.

'I believe nurses have a key role to play in promoting earlier access to palliative care.'

Nurses' role

Palliative care nurse and Macmillan Cancer Care lead for recovery and treatment Danny Bell said nurses can help patients better understand their prognosis.

He said: 'There's a lot of evidence to show patients don't hear everything in consultations.

'Nurses can take the time to understand patients holistically and talk through the options with them.'

Further information

Non-beneficial treatments in hospital at the end of life report

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