Important Factors for Most People at the End of Life

Steinhauser and her colleagues published their survey results in the Journal of the American Medical Association (JAMA) in 2000 on "Factors Considered Important at the End of Life by Patients, Family, Physicians and Other Care Providers."

For this study they had researched nearly 1500 seriously ill patients, recently bereaved family, physicians, nurses, social workers, clergy members and hospice volunteers trying to determine the different factors considered important to people at the end of life.

Different groups placed different levels of importance on certain attributes or factors. Those factors considered to be important for patients more than physicians are in this related article. The Top 10 factors considered to be important to all those surveyed can be found in this related article. This article presents all of the attributes that were considered to be important by more than 70% of all participants.

The List of Attributes or Factors
The attributes or factors on this list are those rated as important by more than 70% of all four of the study groups.

The groups included patients, bereaved family members, physicians and other care providers--social workers, clergy members and hospice volunteers.

Be kept clean.
Name a decision maker.
Have a nurse with whom one feels comfortable.
Know what to expect about one's physical condition.
Have someone who will listen.
Maintain one's dignity.
Trust one's physician.
Have financial affairs in order.
Be free of pain.
Maintain sense of humor.
Say goodbye to important people.
Be free of shortness of breath
Be free of anxiety.
Have physician with whom one can discuss fears.
Have physician who knows one as a whole person.
Resolve unfinished business with family or friends.
Have physical touch.
Know that one's physician is comfortable talking about death and dying.
Share time with close friends.
Believe family is prepared for one's death.
Feel prepared to die.
Having family present.
Writing down treatment preferences.
Not to die alone.
Remember personal accomplishments.
Receive care from personal physician.

Classifying the Factors
This article continues on the next page where these different factors are further arranged into the common groups by Steinhauser to clarify the six major overall areas considered important at the end of life namely:

• Symptoms or Personal Care
• Preparation at the End of Life
• Achieving a Sense of completion about Life
• Decisions about Treatment Plans
• Being Treated as a Whole Person
• Relationships with Health Care Professionals

Source:
Steinhauser KE, Christakis NA, Clipp EC, et. al. Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers. JAMA. 2000;284:2476-2482.

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This article continues on the next page looking at how these factors can be classified.
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© Kirsti A. Dyer MD, MS, FT. Licensed for use to About.com
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