Improving Quality of Life at the End of Life

Advanced cancer patients who received earlier palliative care reported improved quality of life and satisfaction with care

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) End-of-life care that supports dying patients’ needs is often provided when the patient has only two months left to live. But sooner may be better.

Palliative care supports a dying patient’s needs at the end of their life. It can address medical issues, such as pain management, as well as spiritual, psychological, emotional and social needs.

A team of researchers recently conducted a study to see whether earlier palliative care had a positive effect on patients’ end of life.

This study found that quality of life and satisfaction with care significantly improved after three and four months of palliative care.

"Find out how you can support loved ones through end of life."

This research team was led by Camilla Zimmerman, MD, PhD, FRCPC, from the Department of Psychosocial Oncology and Palliative Care at the Princess Margaret Cancer Centre in Toronto, Canada.

This study was done at the Princess Margaret Cancer Centre and enrolled patients with stage III or stage IV cancer, ages 18 and older, with an expected survival of six to 24 months.

Patients were divided into 2 groups, with one group of 233 patients assigned to receive usual care and 228 assigned to receive palliative care.

Initial palliative care was provided by a visit to a palliative care doctor and nurse. Home visits, telephone contacts, monthly follow-up and 24-hour on-call services were part of the on-going palliative care.

The research team used several different surveys to assess the patients’ experience. Data were collected monthly for four months.

The five surveys used assessed therapy and spiritual well-being, quality of life at the end, symptom control, satisfaction with care and difficulty with medical interactions.

By the end of the study, 26 people died and 52 withdrew from the group who had no palliative care. A total of 44 people died and 52 withdrew from the palliative care group.

The researchers found that satisfaction with care increased 2.3 points, from a beginning score of 64, in the palliative care group at the three-month point. The group without palliative care had a 1.75 point decrease in satisfaction with care, compared to their beginning score of 68.

At four months, the changes were greater. The palliative care group had an improvement in their satisfaction with care of 3.7 points from their starting score of 64 and the other group had a decrease of 2.4 points from their starting score of 68.

The palliative care group reported improvement in quality of life at three and four months compared with quality of life at the beginning of the study. The palliative care group showed an improvement of 2.3 points at three months and 3.0 points at four months from their starting score of 73.

The group that did not receive palliative care reported a slight decrease of quality of life at three and four months of less than or equal to half a point, compared with their starting value of 74.

At four months, the palliative care patients also reported improvements in how they felt about therapy and spiritual well-being and symptom severity, compared to the beginning of the study.

The study team noted that limitations of their study were that it was performed at one center and that groups could tell if they were receiving palliative care or not, which may have influenced how they felt about end of life care.

“This study suggests that early palliative care might improve quality of life and increase satisfaction with their care for patients with a large range of advanced solid tumor malignancies,” the authors concluded.

"Removing a terminal patient's 'emotional baggage' or 'trapped emotions' can decrease their level of anxiety and increase their comfort at the same time," said Bradley Nelson, DC, international lecturer in bio-energetic medicine and energy psychology.

"Trapped emotions are energies that are left behind after traumatic or emotionally-charged events. They are common to all of us, and are now being implicated in the formation of diseases, physical pain and emotional disturbances such as depression, panic attacks, phobias and more," Dr. Nelson explained.

"We have developed a simple process known as The Emotion Code, which enables anyone to locate and remove these energies, commonly referred to as our emotional baggage, often to wonderful effect. In fact, it is not unusual for terminal patients to pass away within a short time after this baggage is released, apparently due to their being at peace with moving on," he said.

According to Dr. Zimmerman and colleagues, “Further studies are needed to establish which patients are most likely to benefit; a cost analysis is underway, and will establish the economic implications of implementing this model."

This study by Dr. Zimmerman and team was published in the February issue of The Lancet.

Grants from the Canadian Cancer Society and the Ontario Ministry of Health and Long Term Care funded the research.

The research team disclosed no conflicts of interest.

Review Date: 
February 24, 2014
Last Updated:
February 26, 2014