End-of-life care for veterans with schizophrenia and cancer.
OBJECTIVE
This study compared the quality of end-of-life care between veterans with and without schizophrenia who died of cancer in the northwestern United States.


METHODS
In this cross-sectional study, medical records of 60 veterans with schizophrenia and 196 with no major mental illness who died of cancer were compared on hospice enrollment, palliative and life-sustaining interventions, advance directives, and site of death.


RESULTS
Among veterans with schizophrenia, 58% had an advance directive, 73% received an opiate before hospice enrollment, 63% had a physician order to forgo cardiopulmonary resuscitation, 55% were hospice enrolled, and 27% died in the hospital. Schizophrenia patients had longer hospice stays (107+/-144 versus 63+/-96 days, p=.05) and more physician orders for life-sustaining treatment (15% versus 5%, p=.006) compared with veterans without mental illness.


CONCLUSIONS
On most measures, veterans with schizophrenia who died of cancer received comparable or better end-of-life care than veterans without mental illness.
Ganzini
Linda
L
Mental Health Division, Portland Veterans Affairs Medical Center (VAMC), R&D 66, Portland, OR 97207, USA. linda.ganzini@va.gov
Socherman
Robert
R
Duckart
Jonathan
J
Shores
Molly
M
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D017051:Hospice Care; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D016414:Resuscitation Orders; D012189:Retrospective Studies; D012559:Schizophrenia; D013727:Terminal Care; D014481:United States; D014728:Veterans / Q000523:psychology*