Growing evidence indicates that hospice can provide high-quality care for patients near the end of life and can help their families. However, many patients do not enroll in hospice, and those who enroll generally do so very late in their illness. This article describes a strategy that can make conversations about hospice referral more compassionate, more effective, and—it is hoped—more timely.
The American health care system has long given patients a terrible choice: people told that they have a terminal illness must forgo advanced medical treatment to qualify for hospice care. Cancer patients have to pass up chemotherapy, for example, or patients with kidney failure must abandon dialysis.
Forcing patients into this either-or decision has prompted many who might benefit from a hospice program to instead opt for expensive hospital care that may end up costing Medicare and other insurers far more.
(excerpt from the New York Times, February 10, 2007)
As the self-described “man who would not die,” the humor columnist Art Buchwald was a strange bedfellow with the hospice movement. But in the months between the end of his extended hospice stay and his death from kidney failure on Wednesday at age 81, Mr. Buchwald was a living testimonial to the benefits of hospice care.
(excerpt from the New York Times, January 23, 2007)
There is a widespread belief by some health care providers and the wider community that medications used to alleviate symptoms may hasten death in hospice patients. Conversely,there is a clinical impression among hospice providers that hospice might extend some patients’ lives. For the six patient populations studied, the mean survival was 29 days longer for hospice patients than for nonhospice patients.
Last week, the Supreme Court settled one of the most contentious ethical, moral and legal questions of recent decades, deciding that states may ban doctor-assisted suicide. But the ruling does not settle one of the most pressing crises in modern medicine: inadequate care for patients at the end of life.
That is a problem for the health-care profession to solve, and while ethicists and lawyers have been debating the right to die, doctors have been busy examining their practices and their souls. The universal response, from both advocates and opponents of assisted suicide, has amounted to nothing short of a rallying cry for better treatment for the dying -- in particular, the brand of medicine that Dr. Keay practices, palliative care.
(an excerpt from the New York Times, June 30, 1997)
HANOVER, N.H. — Edie Gieg, 85, strides ahead of people half her age and plays a fast-paced game of tennis. But when it comes to health care, she is a champion of “slow medicine,” an approach that encourages less aggressive — and less costly — care at the end of life.
Grounded in research at the Dartmouth Medical School, slow medicine encourages physicians to put on the brakes when considering care that may have high risks and limited rewards for the elderly, and it educates patients and families how to push back against emergency room trips and hospitalizations designed for those with treatable illnesses, not the inevitable erosion of advanced age.
Phone: 508-957-0200 ♦ Toll Free: 800-642-2423 ♦ Fax: 508-957-0229 E-mail: info@HospiceCapeCod.org We are available to you 24 hours a day, 7 days a week.
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