Last-Ditch Efforts Can Drag Out Suffering

The following statistics are well-known among ethics, palliative care, and critical care professionals.  I am glad they are being reprinted in newspapers across the country.

"More than 80 percent of people who die in the U.S. have a long, progressive illness such as cancer, heart failure or Alzheimer's.  More than 80 percent of them say they want to avoid hospitalization and intensive care when they are dying, according to the Dartmouth Atlas Project, which tracks health-care trends."

Yet that's not what is happening:  

• "The average time spent in hospice and palliative care, which stresses comfort and quality of life once an illness is incurable, is falling because people are starting it too late. In 2008, one-third of people who received hospice care had it for a week or less, says the National Hospice and Palliative Care Organization."


• "Hospitalizations during the last six months of life are rising: from 1,302 per 1,000 Medicare recipients in 1996 to 1,441 in 2005, Dartmouth reports. Treating chronic illness in the last two years of life gobbles up nearly one-third of all Medicare dollars."


• "People are actually now sicker as they die," and some find that treatments become a greater burden than the illness was, said Dr. Ira Byock, director of palliative care at Dartmouth-Hitchcock Medical Center. "There are worse things than having someone you love die," he said.