Video May Help People Make End-of-Life Choices

Seeing what life might one day be like can be powerful, study says

By Steven Reinberg
HealthDay Reporter

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FRIDAY, May 29 (HealthDay News) -- Seeing a video of someone with advanced dementia can help people facing the same fate make more informed decisions about the type of care they want at the end of their life, a new study suggests.

"Medicine is involving patients in a shared decision-making process about their medical care at the end of life," said the study's lead researcher, Dr. Angelo Volandes, from the Department of Medicine at Massachusetts General Hospital in Boston. "But there are challenges to helping patients imagine what some of the diseases and the medical interventions involved are."

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Making such decisions can be difficult and confusing when people have limited knowledge of their condition and the treatment options available, the researchers noted, and sometimes talking alone does not paint the full picture of the course of the disease and care options.

"We have to think of creative and informative ways of improving patients' understanding of these diseases and interventions," Volandes said. Using videos can help, he added.

For the study, published in the May 28 online edition of BMJ, Volandes and his research colleagues randomly assigned 200 healthy people 65 and older to listen to an oral presentation on dementia and to watch a video on advanced dementia or to just listen to the oral presentation.

The participants were then interviewed about their knowledge of advanced dementia, the goals for their care and, for those who watched the video, their comfort with its contents. They were allowed three options for care goals: care that would prolong life by all available means, limited care to maintain physical functioning or care intended to maximize comfort and relieve pain.

Among those who only heard the narrative, 64 percent chose comfort care, 19 percent chose limited care, 14 percent chose life-prolonging care, and 3 percent were uncertain which to choose. For people who saw the video, 86 percent chose comfort care, 9 percent chose limited care, 4 percent chose life-prolonging care, and 1 percent couldn't decide, the researchers found.

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