Institute of Medicine urges reforms to improve care for dying people

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Source: San Jose Mercury News

An influential national institute has prescribed a powerful cure for America's approach to dying, saying that today's health care system is ill-equipped to provide the comfort and care so cherished in our final days.

The long-awaited report released Wednesday by the Institute of Medicine recommends that regular end-of-life conversations become part of patients' primary care, starting at age 18 and that doctors should be paid for time spent on these discussions -- a controversial initiative eliminated from President Barack Obama's health care law.

The report reflects the growing concern over the dizzying array of high-tech interventions to emerge in recent years that prolong futile suffering, often at great emotional, physical and financial cost. Those interventions were the subject of this newspaper's yearlong series "Cost of Dying." To correct the current, misguided course, Medicare should boost coverage for home health services, not just high-tech hospital care, the report urges. And more doctors must be trained and licensed in end-of-life care, through changes in universities, state medical boards and accrediting agencies, it adds.

"Even though death is very much part of the cycle of life, thinking and talking about one's own death usually remains in the background," said Dr. Philip Pizzo, former dean of Stanford University's School of Medicine and a co-chairman of the report.

Read more: http://www.mercurynews.com/health/ci_26551763/national-institute-medicine-report-recommends-ways-improve-end

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Of course this was smeared by Sarah Palin & other rightwingers as "DEATH PANELS." So crazy and out there that Politifact called the "death panel" the 2009 lie of the year.

[Hoppy]

1. Included should be the right to assisted suicide

[starroute]

2. When my father was dying of congestive heart failure, they sent him to rehab

Because that was all Medicare would cover. It doesn't cover any sort of hospice care. So they actually had him up on his feet doing exercises until he got sick enough to go back into the hospital for his last few weeks of life.

Fixing that seems more productive to me than paying doctors to talk to 18 years old about end-of-life concerns.

[SharonAnn]

4. Medicare does cover Hospice care, and has covered it for years.

The requirement, in my husband's case, was that he was no longer receiving chemotherapy or being treated for his incurable condition. Since the chemo had been ineffective and had difficult side effects, he was ready to stop taking it and move into a managed Hospice care situation.

[ripcord]

3. I promised my mother she could die at home

She kept having strokes and finally couldn't walk or use her arms anymore. It finally got to the point where she couldn't even swallow water. Her quality of life was so bad I decided not to do anything to prolong it, she finally slipped into a coma, she came out of it on my birthday long enough to tell me happy birthday and died later that day, having a doctor end her life earlier would have been ideal.