End of life

Medicare May Be Spending Far Less on End-Of-Life Patients Than We Think

You probably have heard the statistic: One-quarter of Medicare spending is for patients in the last year of life.  It is cited as a major reason for excessive medical spending in the US and leads to a widely-accepted conclusion: If only we would stop “wasting” dollars on futile care for those who soon will die anyway, we could significantly slow [...]

By |2018-10-11T09:32:44-04:00October 11th, 2018|End of life, Medicare|0 Comments

Where Do Older Americans Die?

Increasingly, older Americans are likely to die at home, and not in a hospital. And more seniors are using hospice care as they near end of life. However, stubbornly large numbers of Medicare beneficiaries still land in intensive care units or find themselves shuttled from home to hospital and back again in their last months of life. A fascinating and [...]

By |2018-07-01T09:02:56-04:00July 1st, 2018|End of life|0 Comments

Congress Should Not Kill End-Of-Life Talks Just As Physicians And Patients Are Having Them

We may be about to have a new debate over “death panels.” If we do, it would be a tragedy for tens of millions of Americans and their families. You may remember this small piece of the Affordable Care Act that garnered outsized attention back in 2010. It allowed Medicare to pay physicians for having end-of-life conversations with their patients. [...]

By |2017-03-02T09:33:41-04:00March 2nd, 2017|End of life, Medicare|0 Comments

Doctors Die Like The Rest of Us

In recent years, it has become conventional wisdom that physicians avoid the end-of-life mistakes that many of the rest of us make.  The story: They die at home rather than in hospital intensive care units. And they rely on comfort care such as hospice or palliative care rather than often-futile high tech medicine. That conventional wisdom, it turns out, is [...]

By |2016-07-20T09:48:51-04:00July 20th, 2016|End of life, Health Care|0 Comments

Don’t Get Trapped By The Myth Of The “Good Death”

Dying is trendy. I got an email the other morning about “celebrity deaths.”  After the recent demise of David Bowie, Glenn Frey, and “Grizzly Adams,” it seems that everyone is doing it—dying, that is. Apparently, people have been live tweeting the deaths of loved ones at least since 2013. Rock star docs such as Atul Gawande have created their own [...]

By |2016-01-22T10:03:15-04:00January 22nd, 2016|End of life|0 Comments

Americans Want Docs to Talk About End-of-Life.

The public overwhelmingly thinks doctors should have end-of-life conversations with older patients. It even thinks Medicare ought to pay for those talks. It just doesn’t want to have them, at least not yet. Those are results of a new Kaiser Family Foundation poll, which found that 89 percent of respondents felt physicians should discuss end-of-life choices with them. But only [...]

By |2015-09-30T15:50:43-04:00September 30th, 2015|End of life|0 Comments

A New Way To Get Hospice Services Without Giving Up Aggressive Treatment

A new Medicare pilot program will make it easier for patients to access some hospice benefits without giving up standard medical treatment for a terminal disease. It is an important step towards building a health system that fully integrates social, spiritual, and palliative care such as pain management with health care. But it doesn’t get all the way there. Today, [...]

By |2015-07-21T17:46:44-04:00July 21st, 2015|End of life|0 Comments

The Death With Dignity Debate Misses The Point

Ever since the death of Brittany Maynard--the 30-year old with terminal brain cancer who ended her own life last November-- the issue of physician-assisted suicide has received an enormous amount of attention.  Now it is back in the headlines as many states consider laws permitting the practice. It is an important and passionate debate, but for the vast majority of people, it misses [...]

By |2015-03-11T10:32:07-04:00March 11th, 2015|Aging, End of life|0 Comments

Hospice Is Becoming a Chain Business

Large multi-agency, multi-state hospices are fast become the primary source of end-of-life care in the U.S. According to a new study, chains cared for nearly half of all hospice patients in 2011, a dramatic increase from a decade before when small organizations (mostly non-profits) provided three-quarters of all care. And my own review of their financial reports suggests the biggest chains [...]

By |2015-01-14T18:06:48-04:00January 14th, 2015|End of life|2 Comments