Today it was reported that a nonpartisan 21-member committee appointed by the federal Institute of Medicine, which is the independent research arm of the National Academy of Sciences, has issued the results of its investigation into the way the United States’ health care system including Medicare deal with the delivery of treatment at end of life. Their 507-page report is called “Dying in America,” and you can read the report or the abstract at http://www.iom.edu/Reports/2014/Dying-In-America-Improving-Quality-and-Honoring-Individual-Preferences-Near-the-End-of-Life.aspx. Along with recommendations to improve physician-patient consultation on end of life care, they urge Congress to begin looking at ways in which greater Medicare resources could be put towards home health care.
I wrote about this subject in my post on September 5th. There is a tremendous need to educate families and patients about the nature of palliative comfort care (hospice services) at the point in time that continuing treatment of chronic debilitating illness will be of minimal benefit and could cause further misery or suffering. It’s not merely an issue of saving health care resources & outlays — though that will be a likely result. I believe that it is really about enabling patients to come to terms with the declining trajectory of their illness and with their inevitable death so that they can stay comfortably outside the hospital and enjoy what time they have left. Practical, realistic conversations with physicians about the palliative or hospice care options at an earlier point in time would be beneficial to patients who can no longer recover from debilitating chronic illnesses.
The NY Times article is at http://www.nytimes.com/2014/09/18/science/end-of-life-care-needs-sweeping-overhaul-panel-says.html
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