End-of-Life Care Takes Center Stage at IOM

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

End-of-Life CareHome health and hospice agencies are on the front lines of the societal changes around death that are beginning to take place. For most of human history, death was viewed as an expected part of life. More often than not, it took place at home. Today, death is often a medical event involving costly medical procedures in a hospital setting.

The Institute of Medicine of the National Academies (IOM) first addressed this issue in its 1997 report entitled “Approaching Death: Improving Care at the End of Life.” Although the report made sweeping recommendations, few have been implemented. In an effort to underline this important issue, IOM has formed a 20-member panel called The Committee on Transforming End-of-Life Care that met for the first time earlier this month.

Given our aging population and the changes being made as a result of the Affordable Care Act, it seems an excellent time for this type of examination. I know that hospice agency workers will be especially eager to see the committee’s recommendations and have them as a tool to support their own efforts in this area.

The committee plans to look at how end-of-life care is delivered today and what new approaches might make sense. Specifically, it will look at:

  • Delivery of medical care and social support
  • Patient-family-provider communication of values and preferences
  • Advance care planning
  • Healthcare cost, financing and reimbursement
  • Education of health professionals, patients and their loved ones.

We’ll be sure to bring you news from the committee as it releases its findings and makes its final recommendations. We’re hopeful this will be a strong beginning in untangling this affair, which these days involves not only ethical and societal issues, but political ones as well.

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