The ten barriers to appropriate management of patients at the end of their life

Ken M. Hillman, Magnolia Cardona-Morrell

Research output: Contribution to journalArticleResearchpeer-review

18 Citations (Scopus)

Abstract

[Extract] It has been more than 60 years since the concept of intensive care was applied in Copenhagen, Denmark [1], and it was not until the 1970s that the concept became a recognised specialty with its own conferences, textbooks, journals, qualifications and societies. Intensivists have made great advances in how to effectively sustain life and are probably now at the stage where the effective implementation of these lessons is as important as the underlying knowledge.

However, while intensivists have been concentrating on these advances, a major challenge has emerged, almost imperceptibly. The majority of patients we are now treating do not have a single diagnosis; rather, they have multiple age-related co-morbidities that add up to a clinical condition which, as yet, has no universally accepted name or score. Yet, we are still using the same technology to treat these patients that we used previously to treat younger patients who had a single diagnosis and potentially reversible conditions. Many patients now spend their last few days of life on machines, and even the survivors often live a severely compromised existence during their remaining few months of life. How did this happen, and what can be considered the top ten potential barriers to managing patients at their end-of-life (EoL) transition in a more appropriate way?
Original languageEnglish
Pages (from-to)1700-1702
Number of pages3
JournalIntensive Care Medicine
Volume41
Issue number9
DOIs
Publication statusPublished - 29 Sep 2015
Externally publishedYes

Fingerprint

Textbooks
Denmark
Critical Care
Names
Survivors
Technology
Morbidity

Cite this

@article{f5b08ed127e84264aec926576875bbfa,
title = "The ten barriers to appropriate management of patients at the end of their life",
abstract = "[Extract] It has been more than 60 years since the concept of intensive care was applied in Copenhagen, Denmark [1], and it was not until the 1970s that the concept became a recognised specialty with its own conferences, textbooks, journals, qualifications and societies. Intensivists have made great advances in how to effectively sustain life and are probably now at the stage where the effective implementation of these lessons is as important as the underlying knowledge.However, while intensivists have been concentrating on these advances, a major challenge has emerged, almost imperceptibly. The majority of patients we are now treating do not have a single diagnosis; rather, they have multiple age-related co-morbidities that add up to a clinical condition which, as yet, has no universally accepted name or score. Yet, we are still using the same technology to treat these patients that we used previously to treat younger patients who had a single diagnosis and potentially reversible conditions. Many patients now spend their last few days of life on machines, and even the survivors often live a severely compromised existence during their remaining few months of life. How did this happen, and what can be considered the top ten potential barriers to managing patients at their end-of-life (EoL) transition in a more appropriate way?",
author = "Hillman, {Ken M.} and Magnolia Cardona-Morrell",
year = "2015",
month = "9",
day = "29",
doi = "10.1007/s00134-015-3712-6",
language = "English",
volume = "41",
pages = "1700--1702",
journal = "European Journal of Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer",
number = "9",

}

The ten barriers to appropriate management of patients at the end of their life. / Hillman, Ken M.; Cardona-Morrell, Magnolia.

In: Intensive Care Medicine, Vol. 41, No. 9, 29.09.2015, p. 1700-1702.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The ten barriers to appropriate management of patients at the end of their life

AU - Hillman, Ken M.

AU - Cardona-Morrell, Magnolia

PY - 2015/9/29

Y1 - 2015/9/29

N2 - [Extract] It has been more than 60 years since the concept of intensive care was applied in Copenhagen, Denmark [1], and it was not until the 1970s that the concept became a recognised specialty with its own conferences, textbooks, journals, qualifications and societies. Intensivists have made great advances in how to effectively sustain life and are probably now at the stage where the effective implementation of these lessons is as important as the underlying knowledge.However, while intensivists have been concentrating on these advances, a major challenge has emerged, almost imperceptibly. The majority of patients we are now treating do not have a single diagnosis; rather, they have multiple age-related co-morbidities that add up to a clinical condition which, as yet, has no universally accepted name or score. Yet, we are still using the same technology to treat these patients that we used previously to treat younger patients who had a single diagnosis and potentially reversible conditions. Many patients now spend their last few days of life on machines, and even the survivors often live a severely compromised existence during their remaining few months of life. How did this happen, and what can be considered the top ten potential barriers to managing patients at their end-of-life (EoL) transition in a more appropriate way?

AB - [Extract] It has been more than 60 years since the concept of intensive care was applied in Copenhagen, Denmark [1], and it was not until the 1970s that the concept became a recognised specialty with its own conferences, textbooks, journals, qualifications and societies. Intensivists have made great advances in how to effectively sustain life and are probably now at the stage where the effective implementation of these lessons is as important as the underlying knowledge.However, while intensivists have been concentrating on these advances, a major challenge has emerged, almost imperceptibly. The majority of patients we are now treating do not have a single diagnosis; rather, they have multiple age-related co-morbidities that add up to a clinical condition which, as yet, has no universally accepted name or score. Yet, we are still using the same technology to treat these patients that we used previously to treat younger patients who had a single diagnosis and potentially reversible conditions. Many patients now spend their last few days of life on machines, and even the survivors often live a severely compromised existence during their remaining few months of life. How did this happen, and what can be considered the top ten potential barriers to managing patients at their end-of-life (EoL) transition in a more appropriate way?

UR - http://www.scopus.com/inward/record.url?scp=84940451242&partnerID=8YFLogxK

U2 - 10.1007/s00134-015-3712-6

DO - 10.1007/s00134-015-3712-6

M3 - Article

VL - 41

SP - 1700

EP - 1702

JO - European Journal of Intensive Care Medicine

JF - European Journal of Intensive Care Medicine

SN - 0342-4642

IS - 9

ER -