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Editor's e-Note
A new study by researchers at The Ohio State University found that early documentation of hospice patients’ end-of-life wishes reduced undesired interventions and hospitalizations. An analysis of 1,185 cancer patients’ records demonstrated that prominent notes in the electronic health record drawing attention to advance care planning actions decreased the likelihood of hospital admissions, particularly when entered in the record at least six months before patients’ deaths. In addition, the researchers found that a do-not-resuscitate order verified prior to patients’ last 30 days of life reduced the odds of hospitalization.

In addition to reading our e-newsletter, be sure to visit Today’s Geriatric Medicine’s website at, where you’ll find news and information that’s relevant and reliable. We welcome your feedback at Follow Today’s Geriatric Medicine on Facebook and Twitter, too.

— Kate Jackson, editor
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Early End-of-Life Planning Improves Quality of Life

Careful documentation of a hospice patient’s end-of-life wishes—and prominently noting that information in health records early—could prevent unwanted hospitalizations and medical interventions, a new study suggests.

Researchers at The Ohio State University analyzed the health records of 1,185 cancer patients who had been referred to hospice and found that a verified do-not-resuscitate order, or DNR, before the last 30 days of life reduced the odds of hospitalization. A prominent note in the electronic health record (EHR) indicating advance care planning (eg, discussions with providers on legal directives, a living will, or a health care power of attorney) also reduced the chances of admission—especially if that note was made at least six months prior to death.

Once a terminally ill patient transitions into hospice care, the goal is to avoid hospitalizations and procedures that are unnecessary and unwanted, says Laura Prater, PhD, MPH, MHA, the study’s lead author and a postdoctoral researcher in the division of general internal medicine at Ohio State’s College of Medicine.

The aim is twofold: to respect the wishes of the patient and to focus on quality of life and pain management. On top of that, keeping hospice patients out of the hospital reduces medical costs.

“Our research supports the importance of sharing your wishes with your physician and your family, and suggests that doing that earlier can prevent unwanted procedures and hospitalizations that don’t align with your priorities and deteriorate your quality of life,” Prater says.

Full story »
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