End-of-Life Care and Resident Choice

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Hundreds of LTC Leaders and high-level healthcare policy experts gathered in Washington D. C. for a day-long conference on end-of-life care.  The status report was end-of-life care is in shambles. 
Several items came up:
  • A significant disconnect seems to exist between the physician- focused system of treating life –threatening diseases versus the residents’ actual wishes, especially need the end of life.
  • An additional layer of disconnect exists between what residents near death wish for and what they believe their personal rights are.
  • The current Medicare payment system is off-kilter, -a system that encourages people to wait until the very last weeks to seek palliative care.
  • Many insurance benefits still view hospice care as a carve-out an “all or nothing” choice model.
Another news item was presented:  Whether a physician would tell a person about their own dementia-related disease.  Findings indicated that in 55% of cases, physicians would not tell a person of his or her dementia diagnosis. It is of utmost importance to respect people’s autonomy, empower them to make their own decisions and acknowledged that People with Alzheimer’s have every right to expect truthful discussions with their physicians.”  Beth Kallmeyer, MSW with the Alzheimer’s Association.  She also said, “When a diagnosis is disclose, they can better understand the changes they are experiencing, maximize their quality of life and often play and active role in planning for the future.”
What is not broken:  The compassion and care delivery of skilled-nursing caregivers, regardless of the setting.  No one can ever over-value the kind of passion for a job, nor can we under-appreciate the toll it can take on staff who faithfully choose to do that job every day.
Healthcare administrators need to work hard to mesh these issues, to gain better chronic care protocols and much more resident- centered care at the end of life.
For the complete article, click here.



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