IOM: Talking about Death Should Not be Taboo

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Talking about Death Should Not be Taboo

The Institute of Medicine (IOM) believes that talking about death should be a natural part of life, according to a 500-page report from the agency. “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life” takes a look at this critical, albeit uncomfortable, issue that we all will likely face.

While nine in 10 Americans believe it’s important to have end-of-life discussions with their families, fewer than 30% actually followed through. Those who did tended to be white, higher income, over 65 and suffer from one or more chronic conditions.

Changes need to be made across the spectrum of care, starting with each of us. The report suggests that the first conversation could take place when teen-agers receive their driver’s license, the first time many are faced with the possibility of donating one’s organs upon death. The conversation would continue at other significant life events, such as turning 18 or getting married, according to Kaiser Health News.

Following a patient’s directive limiting treatment near life’s end could save as much as $5,600 per death, according to a Reuters article on the report. One healthcare program saved $2,000 per patient per month when treatment was coordinated and better aligned with end-of-life preferences.

As more research comes in, the benefits of palliative and hospice care become clear. I’ve written previously about a study at Mount Sinai Medical Center that showed lower rates of in-hospital deaths and hospital use among hospice patients versus a control group, while producing Medicare savings.

Likewise, a study from Stanford University actually linked late palliative care referrals to a negative impact on outcomes.

I’ll be the first to admit that end-of-life discussions can be difficult to have with your loved ones. But respecting a person’s final wishes is an act of compassion. Agencies with hospice and palliative care programs have an unprecedented opportunity to begin these difficult – but necessary – conversations in their communities.

Learn more about the importance of end-of-life discussions in this blog post about advance care planning.

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