transforming end of life care
TRANSCRIPT
Transforming end of life care:
Why we can’t afford not to
Katherine Sleeman
NIHR Clinician Scientist and honorary consultant
King’s College London, Cicely Saunders Institute
Median age at death
0
10
20
30
40
50
60
70
80
90 women
men1
86
1
18
71
18
81
18
91
19
01
19
11
19
21
19
31
19
41
19
51
19
61
19
71
19
81
19
91
20
01
20
11
Year
Functional decline towards end of lifeFu
nct
ion
100%
Time
19th C
21st C
0%
value =quality
cost
“The experiences of people
who are dying and their loved
ones of the care provided
by the NHS is a recurring
theme in complaints.”
Early Palliative Care: RCT evidenceBakitas,
2009. JAMATemel, 2012
NEJMZimmermann,2014. Lancet
Higginson, 2015. Lancet Resp
Bakitas, 2015. JCO
Quality of life + + + = =
Physical symptoms
= n/a + + =
Depression + + n/a = =
Patient satisfaction
n/a n/a + n/a n/a
Carer outcome = burden n/a + satisfaction= QoL
n/a + depression= QoL
Aggressiveness = + n/a n/a =
value =quality
cost
Curative treatment Palliative
Care
DeathDiagnosis
Curative treatment
Diagnosis Death
Palliative Care
Early Palliative Care: RCT evidenceBakitas,
2009Temel, 2012
NEJMZimmerman,20
14. LancetHigginson, 2015.
Lancet RespBakitas,
2015. JCO
Quality of life + + + = =
Physical symptoms
= n/a + + =
Depression + + n/a = =
Patient satisfaction
n/a n/a + n/a n/a
Carer outcome = burden n/a + satisfaction= QoL
n/a + depression= QoL
Aggressiveness = + n/a n/a =
Survival = + n/a + +
value =quality
cost
@kesleeman
All references available at
https://wordpress.com/post/katherinesleeman.wordpress.com/