JAMA: Delayed hospice transitions undermine palliative care services

Medical advancements in end-of-life care have done plenty to postpone the day when the physician will say, “there’s nothing more we can do.” But aggressive medical treatments toward the very end of life may be denying patients important benefits of hospice care, notes a study published earlier this month in the Journal of the American Medical Association (JAMA).

Between 2000 and 2009, the number of people seeking hospice services nearly doubled. That’s good, long-term care experts say; but far too many of those patients are arriving at hospice too late to benefit from the range of care services provided.

In 2000, 22 percent of hospice patients died within three days of arrival at hospice, but by 2009, that percentage had risen to 28.4 percent. In addition, almost a quarter of these patients had come to hospice from an intensive care unit. Also on the rise is the percentage of those who were hospitalized three or more times in the last 90 days of life, up from 10.3 percent in 2000 to 11.5 percent in 2009, the study showed.

During the end stages of life, hospice provides emotional and psychological support as well as medical care and pain management. And the patient is not the only one who benefits—families and friends also receive important care and support services to help them deal with the loss of a loved one.

“For years the hospice community has been concerned about the growing number of patients who come to hospice within days or hours of dying,” J. Donald Schumacher, president and CEO of the National Center for Care at the End of Life, told the AMA’s news site. “A part of this issue involves patients and families not being aware of the full range of care options available—that would include hospice—when coping with a serious, life-limiting illness.”

For more information on palliative care, visit the National Hospice and Palliative Care Organization.

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