Tag Archives: end of life care

Seniors

The Downside of End-of-Life Care

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It’s a violent procedure, Dr. Helft said, “very invasive and disturbing.” Medical personnel press on a person’s chest with such force that they break ribs. They stab large bore needles into the chest to administer fluids and drugs. They shock the heart with bursts of electricity…

It’s called Cardiopulmonary resuscitation and it’s often futile:

“You can walk around any I.C.U. and see patients who are receiving aggressive therapies where the team decided days or weeks ago that the treatments are futile — these patients are not going to be restored to health.” The patients, he added, “have no prospects of leaving the I.C.U. — they will never wake up.”

Full article on aggressive treatment at the end of life.

Seniors

Obama Targets End-of-Life Care: Critics Say Lives are at Stake

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The charge:

According to Dartmouth, Medicare pays about $50,000 during a patient’s last six months of care by U.C.L.A., where patients may be seen by dozens of different specialists and spend weeks in the hospital before they die.

By contrast, the figure is about $25,000 at the Mayo Clinic in Rochester, Minn., where doctors closely coordinate care, are slow to bring in specialists and aim to avoid expensive treatments that offer little or no benefit to a patient.

“One of them costs twice as much as the other, and I can tell you that we have no idea what we’re getting in exchange for the extra $25,000 a year at U.C.L.A. Medical,” Peter R. Orszag, the White House budget director and a disciple of the Dartmouth data.

The defense:

U.C.L.A. and five other big California medical centers recently published their own research results with a striking conclusion: for heart failure patients, the hospitals that spend the most seem to save the most lives.

Full article on end-of-life care in The New York Times.

Seniors

Should We Spend Less on End-of-Life Care?

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Evan Thomas, in a cover article for Newsweek titled, “The Case for Killing Granny: Rethinking end-of-life care,” writes:

My mother wanted to die, but the doctors wouldn’t let her…. The hospital at my mother’s assisted-living facility was sustained by Medicare, which pays by the procedure. I don’t think the doctors were trying to be greedy by pushing more treatments on my mother. That’s just the way the system works.

New Health Care Law

More on the “Envy of the World”

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More than 1 million British patients are waiting to see specialists: (comprehensive NHS stats on waiting times).

The British way of dying: 16.5 per cent of deaths in Britain came about after continuous deep sedation, twice as many as in Belgium and the Netherlands.

UK end of life care: patients are wrongly being assessed as close to death, then denied food and fluid and sedated with a "chemical cosh" until they die.

Seniors

The American Way of Dying

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While palliative care is available to give patients a chance to die without being tormented by excessive medical care, statistics suggest that in New York, the world center of academic medicine, aggressive treatment is still the rule.

Nationally, nearly 32 percent of dying patients had hospice care….for an average of 11.6 days…. [However,] at Montefiore, only 12 percent of dying patients from 2001 to 2005 entered hospice care, for an average of 4.9 days, during their last six months of life…. At Mount Sinai, it was 14 percent of patients for 4.6 days; at NewYork-Presbyterian, 15 percent for 5.2 days; and at New York University Medical Center, 20 percent for 6.7 days.

Seniors

Zeke Emanuel’s “Thinking Has Evolved” on End of Life Care, “Except in a Few Cases.”

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We previously reported on Ezekiel Emanuel’s views on health care rationing. Now comes this from the Washington Times:

Emanuel said, “When I began working in the health policy area about 20 years ago… I thought we would definitely have to ration care, that there was a need to make a decision and deny people care…  I’ve come to the conclusion that in our system we are spending way more money than we need to, a lot of it on unnecessary care.  If we got rid of that care we would have absolutely no reason to even consider rationing except in a few cases.”

Interesting Links

Hits & Misses – 2009/01/02

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Did you know that the federal government is studying alternative medicine? The findings: Echinacea does not prevent colds. St. John's Wort is not an antidepressant. Overall: "Despite the $1 billion spent in the interim, the center has failed to affirm a single therapy that can withstand the rigors of science."

No insurance? The free market can even handle end-of-life care.  "Lyons is a ‘death midwife,' a specialist in the little-known field of helping people manage the passing of a loved one outside the traditional funeral industry."

Good news about Bush's favorite health plan. "Studies have generally shown that the health centers – which must be governed by patient-dominated boards – are effective at reducing racial and ethnic disparities in medical treatment and save substantial sums by keeping patients out of hospitals."

Michael Moore was wrong. "Foreigners who come to the island for treatment pay cash and suffer no lack of medicines, but ask any Cuban who has set foot in a hospital and he or she will tell you there are severe shortages of medicines and equipment; hospital patients often have to bring their own sheets. In operating rooms, sutures are in short supply and anesthesia is scarce."