August 2010 Terrific NEWS: See article (NYTimes) on new Harvard study - "Palliative Care Extends Life"
Dying Patients Who Acknowledge Terminal Prognosis Less Depressed,
Groundbreaking Study Finds
A groundbreaking Canadian study reveals that terminal cancer patients who are
aware they are going to die are less likely to be depressed than those in
denial. The study is published in the current issue (November-December, 2000)
of the journal Psychosomatics.
"We found that depression was about three times greater in patients who
didn't acknowledge their terminal prognosis," says the study's author, Dr.
Harvey Chochinov, Professor of Psychiatry and Family Medicine, Division of
Palliative Care, University of Manitoba.
"Denial may be a defence mechanism used by some patients to protect them from
death anxiety. But our findings show that denial is often imperfect and
doesn't necessarily eliminate underlying psychological distress," says
The study found that almost 10 per cent of dying cancer patients denied their
terminal prognosis - even though they were hospitalized in palliative care
units. Men were more likely than women to deny that death was near, as were
The study has implications for the care of dying people, says Chochinov.
"When doctors see a dying patient who is in denial, they will know that the
patient may in fact be distressed and quite vulnerable."
Chochinov also found that dying people who were aware of their impending
death didn't necessarily feel hopeless.
"You would think that if people knew death was imminent, they would be more
likely to feel hopeless," he says. "Although each patient's situation needs
separate evaluation, the findings show that giving prognostic information to
patients doesn't necessarily take away hope."
The study, which is the most comprehensive of its kind, was funded by the
Canadian Cancer Society and The Open Society Institute, Project Death in
"Quality of care for cancer patients in the terminal stages of their disease
is extremely important and quite often not enough attention is given to this
stage of the disease," says Dr. Barb Whylie, Director, Medical Affairs/Cancer
Control, Canadian Cancer Society. "These findings will help us to better
understand what happens when people face a terminal prognosis, an unfortunate
reality for many cancer patients."
Chochinov and his team interviewed 200 patients with advanced cancer who were
in their final weeks of life at two Winnipeg palliative care units. The
patients, aged 31 to 94, were asked about their level of awareness of their
prognosis, depressive disorders, demographic and social variables.
Chochinov is also Head, Department of Psychosocial Oncology, at CancerCare
The Canadian Cancer Society is the largest, single non-governmental funder of
cancer research in Canada. The Society also informs the public about risk
reduction/prevention of cancer, provides services for people living with
cancer and advocates for healthy public policy.
For questions about cancer, call the Canadian Cancer Society's cancer
Information Specialists at 1-888-939-9333.
For more information, please contact:
Senior Communications Officer (Research)
Canadian Cancer Society/National Cancer Institute of Canada
Realities of End-of-Life Palliative Care
Family Perspectives:End-of-Life/Last Place of Care
Finnish Docs Responses to Terminal Pt & Unorthodox Thera
Wide Range of DNR Styles and Usage
Symptoms, Treatment & Dying Peacefully: Terminally Ill Pts
Worse QoL for those who die in ICU versus HOME
New York, Times, August 18, 2010
Best Place for Death = HOME
Hospice Care - Advice From A Licensed Funeral Director
Patients wishes often disregarded
MEDSCAPE Med Students,
Deceit Hurts More Than Truth
Communicate with Realism & Hope: Pt Perspectives
Providers & Public Differ on End-of-Life Issues
End-of-Life Discussions BENEFICIAL
Am J Medicine, 10/01
New York Times article, 3/12/02
Defining Dignity in Terminally Ill Cancer Patients
Reuters Health, 5/02
N Engl J Med, 8/02
Nurses' Experiences w/Hospice Pts
Cancer Practice, 11/02
LINK to natl coalition to
improve care/caring at end
of life-resources, information
Arch Intern Med, 10/04
LINK to site with lots
of information and criticisms
of the system
Harvard Med School Study, 6/03
Hospice Referral For Children w/Cancer
Older Adults Receive Intensive Chemo at End of Life
LINK to source to convert
life insurance into $$$
Many other companies too
USA Today, 2/04
Alkaline Hydrolysis or Aquamation.
LINK to site for
LINK to resource
LINK to former Hemlock Society
LINK to free resources & information to help people make decisions about end-of-life care & svcs before a crisis.
J Community Nursing, August 2007
LINK "How to organize a group to
care for someone who is seriously ill"
The Lancet, 6/03
Positive Outlook Comes From Within/Readjustment Constant
Coping Strategies for One's Own Impending Death from Cancer
LINK to resources
A category that is swiftly growing,
thanks to recognition of need
Book: Living Consciously, Dying Gracefully
Final Gifts, a book
Book: "Lean On Me" Cancer Through a Carer's Eyes
The Last Adventure of Life
The Most Important Day of Your Life: Are You Ready?
An explanation of
what, why and a link
Obit: Andrea Martin, Founder The Breast Cancer Fund
Obit: Jessica Grace Wing, composer, Age 31
Josefina B. Magno Dies at 83:Oncologist Founded HOSPICE
Mary-Ellis Bunim, 57, Pioneer in Reality TV
OBIT: Susan Schecter, 57, Author Books on Domestic Violence
LINK: Emotional and Practical Support
for families and caregivers
LINK: "Sacred resources for Living and Dying from a hospice counselor" Maria Dancing Heart
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