Over the next 15 years, the number of people in the U.S. aged 65 and older will nearly double to more than 72 million. As the baby boomer generation continues to age, our society and our health care system will need to address the increasing number of people requiring health care services and end-of-life care.
The federal Institute of Medicine issued a new evidence-based report this month on the best ways to improve the care we provide people at the end of life. The report – written by a committee of 21 health care experts – concludes that we need to overhaul the way we care for patients at the end of life.
Our current health care system is designed to provide life-saving treatment, even when it is clear to doctors and patients that the end of life is near. This results in too many transitions between health care settings – hospitals, rehabilitation and long-term care facilities – that detract from the patients’ final days.
The report found that many people want to alleviate pain and suffering they might experience at the end of life. But because most people don’t have conversations with their doctors about the end of life, patients’ wishes are not always known or honored.
The report also found that medical schools and doctors don’t spend enough time on palliative care, which focuses on improving the quality of life, and many physicians don’t have the communication skills to address these issues effectively.
Methods used by insurance companies to pay for our health care often create incentives to opt for life-saving treatments rather than end-of-life services like hospice and palliative care.
The report offers action steps to improve the way we care for patients at the end of life, including:
- Engage in conversations and end-of-life planning much earlier in life – as young as 16 years old! This means discussing your values and goals with your family members and health care providers.
- Make sure that health care providers are trained in palliative care, including patient communication skills, collaborating with other health care professionals, and managing symptoms.
- Set up health care reimbursement systems that make it easier to choose end-of-life care services such as palliative care and hospice.
- Improve public awareness about end-of-life decision making to encourage people with serious illnesses to think carefully about their choices.
The report includes 500 pages of evidence-based observations and recommendations for our health care system. But the bottom line is this: How each person spends his or her final days is an important topic. As individuals, it’s important to give some thought to this time of life. And as a society, we need to improve our systems for caring for people at the end of life.
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