New research targets end-of-life decision making

As Aotearoa grapples with a strained healthcare system and an ageing population, a new research project is setting out to improve end-of-life care for older people.

Led by University of Auckland Associate Professor Julie Harrison, the study aims to help older people, their families and clinicians make informed decisions about interventions like surgery or extended hospital stays.

“End-of-life decisions are tough, especially in stressful situations,” says Harrison, who specialises in performance measurement within health services, health funding models, and costing systems in healthcare settings.

“We want to find ways to better support kaumātua and their whānau to make choices that align with their values.”

The project, funded by the Health Research Council, will be conducted at Waikato Hospital and involve researchers from the University of Auckland and the University of Waikato.

The researchers will examine how kaumātua and their whānau make health decisions, gather insights from the families of those who have died after a hospital visit, and explore clinicians’ views on informed decision making.

The goal is to create a pathway that supports better decision making, allowing more people to spend their final days at home and reducing unnecessary hospital interventions.

With an ageing population creating a higher demand for health and social care, the project also aims to identify potential cost savings within the healthcare system, which could be redirected to other vital services.

Harrison, who works in the Business School’s accounting and finance department, will focus on identifying the cost side considerations.

“A lot of healthcare costs are incurred at the end of life,” she says, “and decisions around treatment options are challenging for everyone involved.”

Some of the decisions people face in the final year of their life include what kind of health interventions they want - whether they wish to have all possible treatments and potentially spend more time in the hospital or undergo less treatment and spend their final days at home.

“These are hard conversations to have, and we’re doing this study to help understand what people actually want, whether they have the information they need, and the costs of the different options for the system and for families.

“It’s about helping kaumātua and their families to better understand the treatments available and to select the care pathway that best fits what they’re looking for and the way in which they want to spend their final months and days.”