Events and decision-making in the long-term care of Dutch nursing home patients in a vegetative state.
Lavrijsen, J.C.M., van den Bosch, J.S.G., Koopmans, R., van Weel, C., & Froeling, P.
1 January 2005Abstract
Objective
To clarify characteristics of long-term care and treatment of patients in a vegetative state.
Design
Qualitative, descriptive research in a Dutch nursing home.
Methods
Review of clinical records of patients in a vegetative state after acute brain injury between 1978-2002.
Results
Five patients received intensive care from a multidisciplinary team and showed significant comorbidities. There was no standard scenario for end-of-life decisions. Doctors play a more proactive role by evaluating overall medical treatment rather than withholding therapy in case of occasional complications. The attitude of the families is a crucial factor in their final decision.
Conclusions
There is no one-size-fits-all solution for alleviating the fate of vegetative patients and their families. Revoking all medical treatment, including artificial feeding and hydration, may be an acceptable scenario for the patient to die. More research is needed to identify the factors that contribute to the family's acceptance of the doctor's decision.