Hospitals Embrace the Hospice Model

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Hospitals Embrace the Hospice Model

By Dennis

HealthDay Reporter

January 7, 2007

SUNDAY, Jan. 8 (HealthDay News) -- Confronting death,

even in a hospital, can be a terrifying ordeal.

Doctors scramble this way and that. Machines fill the

air with odd sounds. Needles and tests poke & prod.

Above all else, there can be a feeling of utter

helplessness, a sense you no longer control your life.

But now, taking a page from the work of hospices, more

U.S. hospitals are beginning to strive to make the end

of life as natural & comfortable as they can. And a

dignified death is becoming a greater priority in

medical settings, particularly as the huge Baby Boom

population faces its own mortality.

The number of hospitals offering hospice & palliative

care has increased dramatically in recent years, from

632 in 2000 to 1,027 hospitals in 2003, according to a

recent study.

" There's a recognition that it's the right thing to do

for the pt & the family, that anyone with a terminal

condition deserves good palliative support, " said J.

Schumacher, president & chief executive officer

of the National Hospice & Palliative Care

Organization, a charitable organization created in

1992 to broaden America's understanding of hospice

through research & education.

This new interest in palliative care -- which strives

to sustain the quality of life of pts, even if doctors

are still striving to save them -- couldn't come too

soon, said Dr. on, lead researcher of the

study & vice chairman of research in the dept of

geriatrics at Mount Sinai Medical Center in New York

City.

" It's become clear that the care of people with

serious illness in this country needs improvement, "

on said. " Pain is still markedly under-tx'd in

U.S. hospitals. Pts often receive care that goes

against their wishes. Families are increasingly being

burdened with the needs of their sick relatives in the

setting of an unresponsive health-care system. "

For decades, hospice programs have attempted to offer

an alternative to dying in a cold, sterile hospital

room.

Hospice care is designed to provide comfort & support

to pts & their families when a person is stricken with

a fatal & incurable illness, according to the National

Hospice & Palliative Care Organization. A hospice

program addresses all sxs of a disease, particularly a

pt's pain & discomfort. Care also is given for the

emotional, social & spiritual impact of the disease on

the pt & his or her family & friends.

The first hospice program in the United States, The

Connecticut Hospice Inc. in Branford, opened in March

1974. There are > 4,000 today, with > 400 hospice

programs opening in the last 18 months alone,

Schumacher said.

This rise in hospice care makes sense, given America's

aging population.

The total population of elderly Americans is expected

to double by the year 2030, when > 70 million people

will be > 65, according to the U.S. Dept of Health &

Human Services' Administration on Aging.

" With more baby boomers needing end-of-life care,

palliative care is something that needs to be found

acceptable within many hospital settings, " Schumacher

said. " The number of programs is growing, & the number

of pts is growing. "

There's a difference between hospice & palliative

care, although they both focus on helping a person be

comfortable by addressing physical or emotional pain

and suffering.

Hospice care focuses on relieving sxs & supporting pts

who are within hours, days or months of death. Their

tx focuses solely on comfort, not cure.

Palliative care can be given at any time during a pt's

illness, from dx on, regardless of life expectancy.

Pts receive comfort txs even as doctors also seek to

cure their condition.

on said hospitals are ready-made for

palliative-care programs, particularly with pts who

don't have much time left.

" They are a logical place to look at to improve care

for pts with serious illness, " he said. " Just because

you are trying to cure someone or extend their life

doesn't mean they shouldn't have their pain tx'd, that

they shouldn't have their psychological needs met. It

shouldn't be one or the other. Modern palliative care

recognizes that. "

Good palliative care can also provide cost savings to

hospitals, since teams providing the care must match

their actions to the goals set forth by their pt.

" By doing that, you reduce a huge amount of waste, "

on said. " Pts get what they want when they want

it, & nothing they don't want. It's much more rational

care, & it's less expensive for hospitals. "

And, in the end, palliative-care programs are making

things better for all the people hospitals should be

tx'g.

" Their pain gets better, their other sxs get better,

patients feel better cared for, " on said.

" Families are significantly more satisfied when pts

receive palliative care. "

SOURCES: Schumacher, president & chief

executive officer, National Hospice & Palliative Care

Organization, andria, Va; on, MD, vice

chairman of research, dept of geriatrics, Mount Sinai

Medical Center, NYC; National Hospice and Palliative

Care Organization; U.S. Dept of Health & Human

Services' Administration on Aging

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