Majority of older patients want to be told 'bad news'

Study in Galway: Relatives often ask that a serious diagnosis be withheld from older people, and physicians sometimes agree …

Study in Galway:Relatives often ask that a serious diagnosis be withheld from older people, and physicians sometimes agree to abide by their wishes. However, new research has suggested this is often not what older patients want.

A study by doctors at a Galway hospital has found that 84 per cent of patients want to be told when there was bad news.

And surprisingly, a clear majority of patients said they would prefer to be alone rather than with their family when told of bad news.

Some 207 patients were involved in the study at Merlin Park Regional Hospital and their mean age was 63 years.

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They were asked a number of questions on admission to hospital to determine what they would like to be told if they were diagnosed with a serious condition such as cancer or Alzheimer's disease.

It was emphasised to participants that the questions did not imply they were at risk of receiving bad news during their hospital stay.

Some 84 per cent of the 207 patients interviewed said they wanted to be told if they were diagnosed with cancer or dementia, 21 per cent did not want to be told and 4 per cent were unsure whether they wanted to be told or not.

Of those who wanted to be told their diagnosis, 57 per cent said they wanted to be given any bad news on their own, while 40 per cent wanted a family member present and 2 per cent wanted to be told the news by their family.

Of those who said initially they did not want to be told bad news or were unsure whether they wanted to be told it, 82 per cent when questioned further said they would accept being told the diagnosis if the doctors thought it was essential to treatment.

The patients' wishes were recorded and patients were told these would be acted on.

One of the authors of the study, Dr Dominic Keating, said the finding that most patients wanted to be alone when told bad news was somewhat surprising.

"That was unusual because some international studies had shown most patients wanted to be told with somebody else present, but we found the majority wanted to be told on their own by their doctor and both older and younger patients expressed this view," he said.

He said the questionnaire was a very useful tool. Asking the questions took only about five or six minutes and it was very good to know in advance what patients' wishes were.

The study, which has been published in Chest - the official journal of the American College of Chest Physicians - reported: "Relatives often ask that a serious diagnosis be withheld from older people, and physicians sometimes collude with them in maintaining secrecy."

However, it said this research showed that "well-intentioned but ageist attitudes to truth disclosure are indefensible, since older people were no less likely than younger patients to ask to know of bad news".