Tagged: National Hospice

What is palliative, hospice care?

Despite its growing popularity in hospitals, most Americans remain unaware of the comfort and benefits palliative care can provide some terminally ill patients.

“There is a clear need to inform consumers about palliative care and provide consumers with a definition of palliative care,” researchers commissioned by the Center to Advance Palliative Care advise. According to Public Opinion Research on Palliative Care, seventy percent of the general population doesn’t know anything about palliative care, and 14 percent were “somewhat knowledgeable.”

The researchers also found that it is difficult to inform physicians about palliative care, because they often wrongly equate it with hospice or end of life care.

Public Opinion Strategies

Palliative care becoming more popular

Palliative care is treatment that enhances comfort and improves the quality of life for patients in life’s last phase. No therapy is excluded from consideration, according to the National Hospice and Palliative Care Organization (NHPCO).

Palliative care is becoming increasingly widespread. There are more than 1,600 hospitals that have palliative care programs in the U.S., according to Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai School of Medicine. Some 85 percent of large hospitals have a palliative care team. Sixty-seven percent of small hospitals have programs.

Dr. William H. Frist, a heart transplant surgeon and former U.S. Senate Majority Leader, recommends palliative care. ”[A] brand new field in medicine is making chronic, agonizing, and even terminal illnesses much more manageable… palliative care has emerged as the best solution for those facing serious, painful diseases, and introduces the very real possibility… that we can now live with these diseases for a long time,” he wrote recently for The Week.

Public Opinion Strategies

Palliative care also costs much less than aggressive end of life regimens. Patients who receive palliative care services cost hospitals between $1,700 and $5,000 less per admission, according to findings published in the Archives of Internal Medicine.

Hospice care remains overlooked

Hospice care is different from palliative care; its aim is to manage symptoms so that a person’s last days are spent with dignity and quality. The care is not intended to treat the disease but the person, according to the American Cancer Society.

Hospice is most often used when curative treatment is no longer effective, and a terminal patient is expected to live about six months or less.

“Many people believe that hospice is only for people who have cancer. This may be due to the fact that many of the patients cared for in the early days of hospice were cancer patients,” Becky Hillier, public relations director for Rocky Mountain Hospice, wrote for the Montana Standard. Less than 25 percent of hospice patients admitted to the hospice are cancer patients.

The NHPCO reports that 36 percent of hospice patients die or are discharged within seven days of treatment. Many terminally ill suffer more than they need to because they wait to enroll in a hospice program.

“We continue to see more dying Americans opting for hospice care at the end of their lives, yet far too many receive care for a week or less,” said the NCPCO’s J. Donald Schumacher. “We need to reach patients earlier in the course of their illness to ensure they receive the full benefits that hospice and palliative care can offer.”

One reason the terminally ill wait for hospice, he said, is due to the misconception that hospice means giving up.

Learn more from the Life Matters Media Newswire:

Occupational stress: Doctors may suffer when unable to save lives

Terminally ill opt for less treatment when in communication with doctors

Palliative visits provide welcome relief

In America, death is taboo

Are new technologies and medical treatment making Americans less comfortable with death? The Milwaukee Journal Sentinel has published a feature by practicing cardiologist and former hospice director Bruce Wilson. Wilson recounts an experience he had counseling a friend whose mother declined aggressive cancer treatments for her terminal diagnosis. Wilson’s succinct commentary focuses on the taboo nature of death in America and how the culture is changing that.

Wilson writes about when his friend Jack came to him for support: “Jack’s mother had seen her doctor who had ordered a routine CT scan. Unfortunately, there was evidence of the cancer having spread to her liver. She had explored the options with a number of physicians and had decided that she was not interested in chemotherapy or more surgery to treat her spreading, and therefore terminal, disease.”

Like many in his position, Jack was upset that his mother would no longer be accepting of treatment, even though she could possibly recover. This uncomfortable experience would lead Wilson to explain America’s unnerving relationship with death.

Accepting mortality has become harder because death is now so uncommon. According to Wilson: “Death has become a taboo subject, but it hasn’t always been so. It seems to be feared mostly because as a society we have become so unfamiliar with death. Medical science has evolved very rapidly, and over the past 50 years we have become so good at treating illnesses that we somehow have come to view death as an option. Before heart surgery and angioplasty and antibiotics and chemotherapy, people often died when they got sick.”

Since death has become a taboo subject, hospice care, assisted suicide, or “hastened death” as Wilson calls it, are viewed as giving up or immoral. Hospice care is becoming increasingly popular for its cost and comfort focus.

“The number of hospice patients on Medicare doubled to 1.1 million between 1998 and 2008, according to the federal Centers for Medicare & Medicaid Services. Another estimate of hospice patients this year, from the National Hospice & Palliative Care Organization, put the number at 1.6 million,” writes Jim Doyle for the St. Louis Post Dispatch.

There are a growing number of states allowing assisted suicide. Wilson writes: “Many people in the U.S. are now making choices at the end of life that are viewed by some as radical. Physician-assisted suicide is legal in Oregon, Montana and Washington and is on the legislative docket in one form or another in a number of other states. Massachusetts will vote on this in November.” Wilson believes assisted suicide is more about the quality of one’s last days and not the number of one’s last days.

Learn more about the pending Mass. law here.