In recent months some interesting and important information has been published concerning Medicare, palliative and hospice care, and death and dying. Following are lead-ins and links to some of them.
Hospice & Palliative Care
Hematologist oncologist Dr. Jeff Sharman, on one of his blog posts, recommends listening to a podcast of a really good episode of the NPR program series, This American Life. The series producer, Nancy Updike, takes some personal questions about death and dying to a hospice, a place where it’s happening all the time. (audio, 36:00)
The patient education video, What is Palliative Care?, offers an introduction to palliative care, which provides support and relief to any person from the symptoms of cancer or side effects of treatment, regardless of age or type and stage of disease.
In a Kaiser Health News interview, Diane Meier, director of the Center to Advance Palliative Care, discussed palliative and hospice care and the Medicare Care Choices Model, an important Medicare pilot program that would allow hospice patients to receive both curative and palliative care.
Q. There’s a lot of confusion about how hospice care differs from palliative care. Maybe we should start by clearing up what those terms mean.
A. The short, quick elevator answer is that all hospice care is palliative care — but not all palliative care is hospice. Palliative care is a team-based type of care focused on maximizing the quality of life for people and their caregivers at any stage of illness. It focuses on treating the pain, stresses and symptoms of serious illness. The emphasis is on need, not prognosis or how long you might have to live.
March 18, 2014. Today, the Centers for Medicare & Medicaid Services launched an initiative to develop innovative payment systems to improve care options for beneficiaries by allowing greater beneficiary access to comfort and rehabilitative care in Medicare and Medicaid. The Medicare Care Choices Model will test improvements to certain Medicare beneficiaries’ quality of life while they are receiving both curative and palliative care [emphasis added]. More →
August 25, 2014. A study reported in the Journal of Clinical Oncology found that when asked what Medicare should cover for cancer patients in their last months of life, many patients and their caregivers choose benefits the federal insurance does not offer, like home-based long term care and concurrent palliative care, according to a new study based on interviews. More →
October 24, 2014. The National Hospice and Palliative Care Organization released a report, Facts and Figures: Hospice Care in America. Some findings in the report include:
- 34.5 percent of patients died or were discharged within seven days of admission.
- Median length of service continued to decrease to 18.5 days in 2013 (that means half of hospice patients received care for less than 18 days and half received care for more than 18 days).
- The majority of hospice care, 66 percent, was provided in the home, whether the patient’s home was a private residence, nursing home, or residential facility.
- The Medicare Hospice Benefit covered 91.2 percent of hospice care in 2013.
More on Dying
Apparently, so has a recent Atlantic article, Why I Hope to Die at 75, by Dr. Ezekiel Emmanuel, an oncologist, medical ethicist, and one of the country’s leading health care experts.
“Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either.”
Judy Woodruff interviewed Dr. Emmanuel on an NPR NewsHour program to discuss his provocative perspective. (audio, 8:15)
Should you hope to die? Absolutely not! assesses Emmanuel’s argument and suggests where his essay goes off the rails.