The American Institute of Medicine [IOM] released its report September 17, 2014 on the quality of dying in America; if you want to avoid suffering and improve the way you or someone in your family lives and dies, you should read this. A few of its more significant findings:
- People nearing the end of life [EOL] have high rates of preventable hospitalizations which create burdens [and unnecessary suffering] for patients and families.
- Although professional guidelines and expert opinion encourage oncologists [cancer doctors], cardiologists, and other sub-specialty societies to counsel patients about palliative care [PC], “timely referral appears slow”.
- Palliative care is associated with a higher quality of life; PC and hospice patients often live longer than similarly ill patients who do not receive such care.
- Advance care planning is essential because many people nearing the EOL are not always physically or mentally able to make medical decisions. A good advance directive can help ensure that their values and preferences are known and followed.
- People who have declared EOL preferences, choose care focused on relieving pain and suffering. But, since hospitals are primarily “acute care”, advance directives, combined with patient/family discussions with their physician, are needed to ensure preferences are honored.
- Physicians are expected to initiate EOL conversations and ensure that patient/family decisions are based on adequate information and understanding.
- Physicians need training in how to talk to their patients about EOL issues!
- The public needs more education about EOL care issues; we need to ‘normalize’ conversations about death and dying; and to dispel the many myths surrounding EOL care. [two local resources are Dr. Monica Williams-Murphy’s website/book/blog, “It’s Ok to Die”; and my website, Comfortcarechoices.com, which has links to many other reputable sites also.]
- Health care agencies and professional societies should provide information to their patients and encourage EOL discussions.
If you want to read the full report, follow this link