March 21, 2000
PHILADELPHIA (AP) - David Grande knows how to heal broken
prescribe powerful drugs and perform surgery.
though, was only touched on briefly at his medical school.
Yet doctors and student physicians like Grande who lend
empathetic ear to caregivers for the terminally ill
can make a
difference, according to a study published today.
"Doctors who really listen to patients and caregivers
and spend time
understanding, that lessens the burdens on caregivers.
heard. It's a key element to feeling supported,"
said lead researcher
Ezekiel J. Emanuel of the Department of Clinical Bioethics
National Institutes of Health.
Without doctors' intervention, caregivers to patients with a lot
physical needs were significantly more likely to be depressed,
forced to take out loans to pay for health costs and deal with
patients considering euthanasia or physician-assisted suicide.
In the study in today's issue of the Philadelphia-based Annals
Internal Medicine, 42 percent of caregivers with non-empathetic
doctors reported depressive symptoms, compared to 27 percent
those with an empathetic doctor, the study showed.
Helping doctors empathize could be taught through a more
formalized and structured curriculum during medical school,
internships and residency trainings, the study said.
Such teachings could make the dying experience more pleasant
everybody, Emanuel said. Caregivers with a good attitude
even make terminally ill patients feel less guilty about the
they may put others under.
Better training for doctors may also reduce the chances
will undergo costly medical care for their own
depression, he said.
Too often, though,
doctors aren't trained that way.
"In the later years, there were no role models practicing these
things, so it's difficult to expect students to learn it and put
skills in action in their own practice," said Grande,
president of the
American Medical Student Association in Reston, Va.
Managed-care groups refer patients to community-based
organizations that could provide such services without
said Mohit Ghose, spokesman for the Washington-based
Association of Health Plans, the largest trade group
managed care plans.
"But a study like this takes us into that next level of
how to include such benefits in a standard package
in taking care of
hospice patients," he said.
The study was conducted in six randomly selected cities
terminally ill patients with different illnesses
and 893 caregivers.
Previous studies showed that terminal illnesses create high
economic burdens, but they did not say why.
The latest study
shows that high caregiving needs, like transportation,
and personal care, are the driving cause
behind a caregivers'
depression and financial problems.
For the last 26 years, Suzanne Mintz, president of
Family Caregivers Association in Kensington, Md.,
has been a
caregiver to her husband who suffers from
multiple sclerosis. She
said the study is a wake-up call
to physicians and HMOs.
"Although their legal responsibility is to the patient,
the concept of
illness and disability is a family affair," Mintz said.