End-of-Life Care is Back in the News

Before I begin, let me wish you all a Happy Holiday season! My New Year’s wish is that the new found camaraderie of the lame duck session continues with the 112 Congress! Do you remember (you would have an awfully short memory if you forgot!) last year’s hysteria about the government’s “death panels” to kill granny? This occurred over a proposal to encourage voluntary end-of-life planning. It created such a hoopla that the language was dropped from the healthcare reform legislation.

Well, while we’ve been Christmas shopping the Obama administration has quietly achieved the same goal by regulation beginning January 1. Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.  Before you get your panties into a wad, this regulation has always been a part of Medicare’s “Welcome to Medicare” free physical examination. Believe it or not, planning for our end-of-life care not only leads to a better quality of life, but it also extends the number of months you live at the end-of-life.

A few months ago, the NY Times reported the results of the first clinical trial to determine whether palliative care (comfort care, the kind you would receive if you decided against heroic efforts to prolong life) resulted in better outcomes than aggressive care for patients with terminal advanced lung cancer.

The results were astonishing and should certainly put to rest the notion of “death panels”. Patients treated with palliative care not only were happier, more mobile and in less pain as the end neared, but they also lived nearly three months longer!!

More than 80 percent of people who die in the United States have a long, progressive illness such as cancer, heart failure or Alzheimer’s disease. Yet, 90% of the countries ICU beds are occupied by people being kept alive by machines. Numerous surveys have showed that more than 80% of us do not want to be in pain or in the hospital in our final days. However, our wishes are often ignored because we haven’t taken the necessary steps to ensure that what we really want is followed. We’re not talking about death and dying with our loved ones, and we haven’t drawn up the necessary legal documents (advance directives) for our wishes to be followed. Instead, we wait until there’s a medical crisis and often it’s too late because the “train has now left the station”. And, don’t expect doctors to initiate such conversations because they’re taught to fight death with every last ditch effort known to medicine. What then usually happens is we get sicker as we die because the treatment becomes a bigger burden than the disease.

So, use this regulation to sit down with your doctor and family and plan how you want to live out your final days. Take control of your healthcare so you recieve the care you want.

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