Peer mentoring helps with end-of-life decisionmaking

An article just published in the American Journal of Kidney Diseases examines the role of peer mentors in facilitating discussion and completion of advance health care planning documents.  From Reuters Health:

Peer mentoring, in which trained patients educate other patients,offers a culturally sensitive way to inform dialysis patients abouttheir condition and treatment options, new research suggests.

Within cultural groups with oral rather than written traditions, thisperson-to-person approach appears to encourage discussion about livingwills (advance directives) and end-of-life decision-making.

Because of the high death rate among dialysis patients, death andend-of-life discussions are critically important for the dialysiscommunity, Erica Perry, from the National Kidney Foundation of Michiganin Ann Arbor, and colleagues note in the American Journal of KidneyDiseases this month.

They explored the impact of peer mentoringcompared with standard printed materials on end-of-life decision-makingin 203 dialysis patients.

The mentors attended a workshop onadvance directives, and received training through role-playing anddirect instruction on communicating about end-of-life planning.

During the study, patients assigned to peer intervention were contactedeight times by mentors to talk about coping with chronic illness, theimpact on family, and eventually the value of completing a living will.

Compared with standard printed materials, the use of peer mentoringsignificantly increased the odds that advance directives would becompleted (12 percent vs. 35 percent), the authors report.

The full article, Peer Mentoring: A Culturally Sensitive Approach to End-of-Life Planning for Long-Term Dialysis Patients
Erica Perry, June Swartz, Stephanie Brown, Dylan Smith, George Kelly, Richard Swartz

is available from the AJKD