{"id":800,"date":"2023-10-17T20:21:50","date_gmt":"2023-10-17T20:21:50","guid":{"rendered":"https:\/\/evidencetoprac.wpenginepowered.com\/?p=800"},"modified":"2024-01-31T18:19:09","modified_gmt":"2024-01-31T18:19:09","slug":"end-of-life-care","status":"publish","type":"post","link":"https:\/\/etpractice.com\/end-of-life-care\/","title":{"rendered":"End-of-Life Care"},"content":{"rendered":"

What is end-of-life care?<\/span><\/h3>\n

End-of-life care<\/span><\/a> (EOLC) is care administered to those near the end of life and can include physical, emotional, social, and spiritual support for patients and their families. EOLC may include palliative care or hospice care. Regarding palliative care, anyone with a serious illness can be treated, and continuing curative treatments are an option. <\/span>Hospice care<\/span><\/a>, on the other hand, is limited to patients who have a short time to live, typically less than six months. Additionally, curative treatments must be discontinued to enter hospice care.\u00a0<\/span><\/p>\n

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Challenges<\/span><\/h3>\n

The United States spends the most on healthcare compared to other countries. At nearly <\/span>18%<\/span><\/a> of gross domestic product (GDP), US healthcare costs are nearly double the average of other high-income countries. Additionally, <\/span>25%<\/span><\/a> of total Medicare spending is used in the last year of life for beneficiaries over 65. Despite these allocated resources, <\/span>life expectancy<\/span><\/a> remains lower than average, and the <\/span>quality of death index<\/span><\/a> is among the lowest of the developed countries. The disconnect between the generous number of resources used and poor conditions around dying provides insight into the problems within the current EOLC systems. Studies have shown that patients often die not in their <\/span>place of choice<\/span><\/a>, experience <\/span>psychological distress<\/span><\/a>, and <\/span>regret<\/span><\/a> how their last moments were spent. Some treatments that produce marginal or no benefits are also encouraged, increasing healthcare costs while worsening end-of-life experience.<\/span><\/p>\n

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With the growing population size of older adults, the problems seen with end-of-life treatments will soon be exacerbated. By 2040, the number of individuals ages 65 and older is projected to <\/span>double<\/span><\/a>, reaching approximately 80 million people. Contributors to the inadequate handling of EOLC include the United States\u2019 mindset towards death and physician training on the subject. The long-standing goal of our medical system has been to prolong life. With <\/span>rhetoric<\/span><\/a> such as \u201cWar on Cancer\u201d and \u201cbattling\u201d disease, we view death as something to be conquered instead of a natural state. Because of this, unnecessary treatments are administered to adhere to this survivalist mindset. <\/span>Cardona-Morell et al<\/span><\/a>. found that, on average, 33-38% of patients received non-beneficial treatments in the last six months of life. Not only is this care ineffective and costly, it also confines patients in the curative phase and impedes transitioning into comfort care. The lack of physician training also influences the quality of EOLC. One study found that only <\/span>18%<\/span><\/a> of medical students and residents were trained in EOLC procedures, and <\/span>40%<\/span><\/a> of residents felt unprepared to advise on EOLC matters. This insufficient training inhibits the provider’s ability to facilitate conversations around death and to understand patient concerns. However, <\/span>research<\/span><\/a> has shown that patients who have had these conversations found them beneficial to both themselves and their caregivers and appreciated the opportunity to make their perspective known.<\/span><\/p>\n

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Opportunities<\/span><\/h3>\n

To provide quality end-of-life care, patient-centered outcomes should be prioritized. For example, one <\/span>study<\/span><\/a> interviewed patients and providers on their perspectives surrounding dying and end-of-life care. Researchers found that patients frequently lacked clarity on EOLC options and were worried about unwarranted efforts to prolong life. Understanding this as a common concern, providers can then use this information to inform their discussions and promote transparency. Qualitative research can also be utilized to understand provider reservations around conducting EOLC conversations. Not only would this research promote a more positive patient experience, but it would also facilitate open and honest conversations around dying, potentially increasing our comfortability with the idea that death is a natural state.<\/span><\/p>\n

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Want to Learn More?<\/span><\/i><\/h3>\n

Evidence to Practice has extensive experience involving qualitative research, patient-centered outcomes, and engaging community members. Working with us, clients can expect a professional and personalized experience, clear communication, and quality deliverables.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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