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 “Consistent with other studies demonstrating benefit, the use of
hospice care is associated with better quality-of-care outcomes,
including patient-centered care metrics,” study leader Ruth
Kleinpell and colleagues write in the journal BMJ Supportive and
Palliative Care, online August 16.
In other words, Kleinpell told Reuters Health, “Hospice care can
provide patients and families with a better dying experience.”
The research team studied more than 163,000 patients enrolled in
Medicare, the U.S. government’s insurance for the elderly and
disabled, who had died in 2010. All had been hospitalized at least
once in the previous two years for a chronic illness associated with
high mortality rates.
Roughly 47 percent of patients were in hospice in the last six
months of their life. Hospice admissions were tied to a number of
variables, the team found, including higher patient satisfaction
ratings, better pain control, reductions in hospital days, fewer
deaths in the hospital, and fewer deaths occurring with an ICU stay
during hospitalization.
In the U.S., Medicare provides hospice benefits for patients who
aren’t expected to live more than six months. Those benefits include
medications, equipment (such as hospital beds, wheelchairs, commodes
and oxygen), home visits from nurses, chaplains and social workers,
and other services for the patient and family members.
“The majority of patients today still die in hospitals,” said
Kleinpell, a professor at the Rush University College of Nursing in
Chicago who works in a critical care unit at Rush University Medical
Center.
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“If someone is hospitalized and approaching the end of life, hospice
care is more optimal so they can get the care they need,” she told
Reuters Health by phone.
Susan Miller, who specializes in hospice and palliative care at
Brown University School of Public Health in Providence, Rhode Island
but who was not involved with the current study, said for patients
nearing the end of life, hospitals’ palliative care teams “typically
address management of symptoms such as pain and include discussion
of goals of care including the choice of hospice.”
“Hospice care offers symptom management, emotional and spiritual
support, and it's a Medicare benefit,” she said.
What’s most important is that patients and their families have
crucial conversations about hospice care with their doctors,
Kleinpell said.
“Patients should be enrolled in hospice early," she said, "so when
conditions worsen, they and their family members get the appropriate
help to prepare for what’s next.”
SOURCE: http://bit.ly/2c5phVV
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