Panel Finds End of Life a Struggle for Most

A panel convened to explore the end of life has found that, despite research progress, some aspects of the stage remain poorly understood and for many people, noncontinuity of care and poor communications among patients, doctors, and family members make this period a struggle.

The panel, convened by the U.S. National Institutes of Health (NIH, Bethesda, MD, USA), called for the rapid development of research to improve the understanding of what works and what does not work in different groups of patients, and for enhanced resources to deliver quality care to patients and their families at the end of life. The panel also concluded that current Medicare hospice benefits limit the availability of the full range of interventions needed by many people at the end of life. For example, the eligibility requirement is a prognosis of six months or less to death, which raises problems. So does the forced selection of either skilled nursing or hospice care for patients entering nursing homes from hospitals, and the limits placed on certain therapies such as radiation, which may help manage symptoms.

The panel concluded that communication among patients, families, and providers is crucial to high-quality end-of-life care. Future studies, said the panel members, should recruit under-represented populations. Also, new networks of end-of-life researchers should be created and also well-defined cohorts of patients to facilitate the design of studies.

"We can begin by refining and agreeing upon our definitions of ‘end of life,' ‘palliative care,' and ‘hospice'--the terms have been used inconsistently and often interchangeably, which hinders not just the research enterprise but also effective communication between providers and patients as well,” said panel chair Margaret M. Heitkemper, Ph.D., R.N., professor and chair of the department of biobehavioral nursing and health systems at the University of Washington School of Nursing in Seattle (WA, USA).




Related Links:
National Institutes of Health