WBUR radio and Kaiser Health News report that the Massachusetts Senate has quietly approved a measure requiring doctors and nurses to discuss end of life options with patients who have a terminal illness. The Palliative Care Awareness bill was included as part of a sweeping health reform measure and, remarkably, was not controversial. It was supported by both Republicans and Democrats and [...]
I recently had the opportunity to participate in a panel on end-of-life care jointly sponsored the Charles E. Smith Life Communities in Rockville MD, Suburban Hospital in Bethesda, MD,, and Sibley Hospital in Washington, D.C. The session was part of a day-long program on care transitions and highlighted the special importance of caring for the dying. My fellow panelists and I brought a wide [...]
Yesterday, I participated in an AARP program with several authors of books on caregiving. One fellow panelist, the novelist Walter Mosley, was wonderfully provocative as he reflected on what he calls “the great equalizing effect of great age.” Mosley, whose mother was Jewish and whose father was black, put it this way: “White people become black people when they can [...]
I am a huge fan of efforts to increase awareness of palliative care among physicians, health systems, patients and their families. And I wanted to pass on information about three major efforts to do that. The first is a landmark study by the prestigious Institute of Medicine on the importance of managing pain. The report, Relieving Pain in America: A Blueprint [...]
We all know the sad story: Despite extensive rehab, a patient in a skilled nursing facility is failing. Instead of improving, she is finds herself returning to the local hospital with trouble breathing, heart failure, or unmanaged pain. Eventually, she may die in the hospital hooked up to a ventilator and feeding tube that she never wanted. A team at [...]
More than 8,000 general practitioners in the United Kingdom will soon begin displaying in their offices seven "end-of-life" promises to their patients. It is a great idea. According to an article in The Independent, every GP (much like primary care physicians in the U.S.) will post this end-of-life pledge on the wall of their waiting room. The Charter for End of [...]
For the second time, President Obama has bowed to conservative critics and backtracked on a plan to allow Medicare to pay physicians for end of life consultations with their patients. He should be ashamed. In late November, the government adopted new rules that included discussion of advance directives as one of many services physicians could provide during routine annual physicals for their Medicare patients. [...]
The Obama Administration has decided to pay doctors for discussing end of the life issues with their Medicare patients. You may recall that this would have been permitted by the 2010 health law, but the provision was dropped in the face of withering criticism by opponents of health reform, who dubbed these important conversations "death panels." The new rules are an important first step. Doctors absolutely [...]
An important new study finds that patients with metastatic lung cancer who received early palliative care both lived longer and reported a better quality of life than similar patients who had only standard cancer treatment. Palliative care focuses on treating symptoms, although, unlike hospice, patients may still receive treatment for their terminal disease if they wish. Palliative care also coordinates [...]
Mike Vitez at the Philadelphia Inquirer has done a great story on palliative care at a community hospital. Mike weaves the deeply touching story of Mary Tole, a 74-year-old woman who spent two months in the suburban Philadelphia hospital with an undiagnosed illness. She spent much of that time in an intensive care bed in a coma. Mike describes how the hospital's palliative care team [...]