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Shorter Hospice Terms Point to Missed End-of-Life Opportunities

Hospice care can help patients and families dealing with distressing physical and mental symptoms at the end of life. (Pixabay)
Hospice care can help patients and families dealing with distressing physical and mental symptoms at the end of life. (Pixabay)
October 16, 2017

DENVER - More than 40 percent of Medicare patients received just 14 days or less of hospice care in 2015, according to new data.

People facing terminal illnesses frequently turn to hospice care, a combination of medical experts, pain management and emotional and spiritual support tailored to each patient's needs. Edo Banach, president and chief executive of the National Hospice and Palliative Care Organization, said hospice's interdisciplinary approach works best not just in the final days but over the last months of a patient's life.

"You really have an ability to begin to make some changes that are going to make people more comfortable," he said. "Less than that, you're really doing the best you can do, but you're not having as much of an impact on an individual's life and making their life as comfortable as it can be."

Banach said it takes time for the team to work with patients, who may be transitioning from nursing homes, on what their wishes are - and to work with families to put a plan in place for medications, counseling and bereavement services. The report found 46 percent of Medicare recipients received at least one day of hospice care at the time of death, but nearly three out of four received less than 90 days of care.

New strategies are needed to get more people the help they need when dealing with the physical and mental symptoms, and disabilities with which families can struggle at the end of life, Banach said. He noted that the interdisciplinary hospice model, which provides not just medical care but psycho-social care as well, could become even more important as the nation grapples with mass shootings and climate change.

"And in this time when we're dealing with wildfires, and we're dealing with hurricanes, and we're dealing with opioid crises," he said, "I do want to think about how a model that provides for all those other services and provides bereavement services might have a really strong role to play in the future of health care in this country."

The report found that not all Americans benefit from hospice care equally. Banach said African-Americans in particular continue to be underserved both in terms of the number of care days and the number of patients receiving care.

The report is online at nhpco.org.

Eric Galatas, Public News Service - CO