After practicing Family Medicine in the Central Arkansas region for over 15 years, I made the decision to start doing home visits with a focus in Hospice Care. I could write a lengthy article on how to avoid getting dog bit however I will reserve this topic for another time.
It’s not surprising that patients in their last year of life consume a disproportionate share of the medical resources. One percent of the population account for nearly 30 % of the nation’s health care expenditures. Nearly half of those patients are elderly.
What can we do as Physicians to help with this problem? One of the most difficult decisions that patients, families and physicians face involves end-of-life care. The advance directive or “living will” has become an accepted framework for many patients to delineate their own preferences about what treatment they would or would not want when faced with a life-threatening disorder.
The National Hospice and Palliative Care Organization estimates that 2010, 41.9% of all deaths in the United States were under the care of a hospice Program. When Hospice care was established in the 1970’s cancer patients made up the largest percentage of hospice admissions. Today, cancer diagnosis account for less than half of hospice admission, with the majority of deaths being due to other terminal illnesses.
The Medicare hospice benefit, enacted by Congress in 1982 is the predominate source of payment for hospice care. In 2010 95% of Hospice Patients received their care in their homes. 75% of individuals rated the quality of care they received as “excellent”.
I encourage health care providers to begin the discussion about what Hospice can offer for your patients near the time the diagnosis of a terminal illness is made. Many family members I work with tell me they wish that they knew about Hospice much earlier in their lives. Talk to a Hospice Doctor before a patient is discharged from the hospital to help coordinate the care.
Hospice can be considered the model for quality compassionate care for people facing a life limiting illness. Patients can receive emotional and spiritual support tailored to their own needs and wishes and support is proved to the loved ones as well.
Hospice services are available to patients with any terminal illness and include all ages, religion and races.