Attitudes about Palliative Care and Hospice Slow to Change

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Hopsice Agency Care

As more Americans shift to high-deductible health plans and industry reforms take hold, people are paying increasing attention to how their healthcare dollars are spent.

But for most Americans, that attention does not include end-of-life care, with a majority (55%) of respondents to a recent poll indicating the healthcare industry has the responsibility to spend whatever it takes to extend the lives of seriously ill patients.

Despite the increased acceptance of hospice services, the industry still has its work cut out for it on both national and local levels.

“In Europe, the general feeling is that death is inevitable, but in America, death is considered optional,” says Michael Galazka, CEO of the Hospice Education Institute, a nonprofit founded in 1985 that works directly with hospices, caregivers and patients to encourage the concept of good hospice care.

Galazka recalls the furor over the supposed “death panels” that critics of healthcare reform floated in an attempt to derail the legislation in 2009. “It was a totally inappropriate argument but it was totally effective,” he says.

The Regence Foundation conducted a series of polls called “Living Well at the End of Life: A National Conversation.” A group of board-certified physicians were polled several months after a  group of Americans, and some of their beliefs about palliative and hospice care were quite striking.

While 96% of the physicians believed that enhancing the quality of life for seriously ill patients was more important than extending life as long as possible, only 71% of Americans believed this. Likewise, 55% of Americans said the industry has a responsibility to extend life as long as possible – a view shared by only 21% of physicians.

Galazka says the conversation about end-of-life care should start with the family doctor or attending physician. However, two-thirds of physicians who have discussed palliative care with patients say they are not well-informed about their options. And one-quarter admit reluctance to recommend palliative care out of fear patients will say their physician isn’t doing everything possible to preserve their life.

Hospice workers know better than most that conversations about death and dying are difficult. But they also know that the sooner these conversations take place, the better a patient’s remaining days can be.

Galazka says that many hospices “do a splendid job” of initiating those conversations but that many more “still have a great deal to do.”

So what group does your hospice agency fall into? And what are you doing about it?

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