By Ian Richards
Healthcare providers are experiencing great success in improving communication between doctors and their patients about end-of-life treatment by utilizing videos demonstrating medical options. This technique is featured on the front page of The Washington Post Health & Science section.
“The video was direct and dramatic. In a demonstration of cardiopulmonary resuscitation, or CPR, a technician pushed down hard on the chest of a dummy. A white-coated doctor narrating the video laid out grim odds:
“‘Most of the time, in patients with advanced disease, CPR does not work,’ she said. As a result, patients need a ventilator to help them continue breathing.
“[Ted] Goff watched a technician maneuver a metal instrument down the dummy’s throat to prepare for insertion of a tube that pushes air into the lungs. Then the camera zoomed to a close-up of an elderly patient, eyes closed, in a hospital bed. He had a breathing tube in his mouth. Equipment surrounded his bed.
“‘You cannot eat or talk while on this machine,’ the doctor on the video said …
“‘I ain’t gonna do that,’ his wife, Linda, recalled the retired businessman saying …
“In clinical trials, researchers found that dying patients were less likely to want aggressive end-of-life care if they had watched the videos than if they had simply been told about the procedures.
“Angelo Volandes, an internist and researcher at Harvard Medical School and Massachusetts General Hospital, co-founded the nonprofit foundation [Advanced Care Planning Decisions] in 2010 that makes and distributes the videos.
“’What we’re finding is [that] the videos spark the conversation,’ he said. ‘It flips the power structure of the patient-doctor relationship.’
“More than 50 health-care systems — including all hospitals in Hawaii, the Everett Clinic in Washington state and Kaiser Permanente — are using the videos, Volandes said.”
Patients and their families give overwhelmingly positive feedback on the videos because they find it easier to absorb information from a video than from a long conversation with a physician. The videos also give patients peace of mind by showing them all of their options at the end of life.