Atul Gawande’s New York Times bestseller, Being Mortal: Medicine and What Matters in the End offers great insight on end-of-life care care. He makes a strong case that medical care should be directed towards well-being rather than survival. Gawande discussed at length how people with age-related frailty, serious illnesses or those nearing death can live better and more meaningful lives. He advocates changing ways in which medical professionals deal with patients with chronic illness and those nearing death. Practitioners should seek to build on the quality of life and well-being of the patients instead of solely being focused on survival. Gawande’s best selling book is part of a wider trend: increasing prevalence of Palliative and Hospice Care. Here are 5 reasons why Palliative and Hospice Care is on the rise:
Greater Acceptance for End-of-Life Care
- According to a new study, COVID-19 has pushed more and more Americans to discuss options available to them for end-of-life care. Healthcare professionals have an important role to play in kicking off conversations around end-of-life care. Most of the respondents in the study (69%) said that they prioritize their decisions and wishes for end-of-life care. Families often remain unaware of what their loved one desires when they fail to have open conversations over care wishes. In the study, 1 in 5 respondents reported having lost a loved one who was critically ill, all the while not knowing their values for end-of-life care.
- Dr. Joe Shega in the following post suggests,
“New research has demonstrated the impact of the pandemic on end-of-life decision-making. Now is the time to talk to patients about documenting their wishes and goals for care. As clinicians, we have a responsibility to have this conversation because, as the study shows, patients are expecting us to initiate it,”
- Clearly, there is a rising trend among Americans looking more towards end-of-life care options, and a greater acceptance at that.
More Training Available for Professionals in Palliative Care and Hospice
- The availability of Palliative Medicine practitioners lags the need in the United States, and the majority of end-of-life and comfort care discussions falls on the shoulders of general practitioners. The way to get around the scarce number of palliative medicine specialists is providing healthcare professionals the training to properly converse with patients reaching end-of-life situations. Stanford University is carrying this initiative forward. The Palliative Care team trains providers ranging from physicians, advanced practice providers to nurses and everyone else involved in tending to the needs of terminally ill patients. The main idea behind this is to improve communication between provider and patient.
- In a recent article, Stephanie Harman (Medical Director of the Palliative Care Services) suggests that,
“Studies demonstrate that physicians think these types of conversations are important to understand what matters most for patients who have serious illness,…but less than half feel comfortable knowing what to say. That’s the gap we want to help address.”
- Providers must be taught how to deal with patients and their families in order to tell what is most important for them. This makes it possible for them to align care according to their needs. Nurses have an important role to play as well in end-of-life care and so training must be provided to them as well. In the Stanford program, the training included computer module work, classroom education, several hours of patient simulation as well as having to work with actors in emotionally charged scenarios.
- According to Stephanie Harman, “There is no shame in saying these are hard conversations, Training is a great stress reliever. It’s important that staff have the education and background to feel equipped.”
More Medical Schools Investing in Palliative Education
- The trend in palliative care education programs seems to be gaining momentum. According to one study, the majority of students in clinical disciplines feel ill-equipped to provide care in end-of-life situations. However, more educational institutions are now leading the way for hospice and palliative care clinical training. One example of that, is CARE-7, a four-year palliative care curriculum that has been initiated by the Perelman School of Medicine at the University of Pennsylvania.
- Dr. Alana Sagin, associate professor of hospice and palliative care at Perelman and CARE-7 curriculum director mentions in the following article,
“As these programs grow, I think it will become more apparent just how essential these skills are. Those who pave the way really do make it easier for others to follow. I hope it will change culture enough that a curriculum like this will be an expected part of medical education.”
- More and more academic institutions are realizing that this is a skill set essential to healthcare providers in order to deal more effectively with terminally ill patients. Various universities have started new programs in hospice, palliative care and other home-based health services, such as the University of New Mexico. For instance, the New Mexico Health Sciences has started a new palliative program with the aim of providing better care to patients faced with serious illnesses or nearing death.
Global Awareness through World Hospice and Palliative Care Day
- The World Hospice Palliative Care Alliance came out in response to a meeting of healthcare leaders, all who met in South Korea in 2005. In those discussions, it became clear that their concerns largely revolved around patients approaching the end of life.
- WHPCA Executive Director Stephen Connor, was recently quoted as saying, “We met because we recognized the fact that no one was really speaking up about palliative and hospice care in the policy arena. WHPCA was then formed, and one of the first things we did was set a day aside for global recognition, because most of every major issue in healthcare worldwide centered around what was happening in the last years of life.”
- World Hospice and Palliative Care Day creates awareness of serious illnesses and end-of-life care. The goal is to highlight patients’ and families’ care needs and educate not only them, but also policymakers and clinicians alike on all available resources.
The Silver Tsunami and An Aging Population
- The silver tsunami is no longer a future phenomenon. The total population of seniors is drastically rising through 2060. According to experts, seniors will gofrom 16% to around 23% of the total American population.
- The U.S population will have 19.7 million people in the age category of 85 and above by the year 2060. As people age, they naturally need more healthcare and must consider end of life wishes. The silver tsunami is likely to affect American society in a myriad of ways: one is possibly the rise in demand for healthcare and long-term care services.
- The fact of the matter is that there will be a larger number of people reaching the end of life in the next couple of decades than in the past decades and more palliative and hospice care will result from this trend.
(1.) Pandemic Has More Americans Open To Planning For End-Of-Life Care. April 5, 2021.
(2.) Being Mortal. https://en.wikipedia.org/wiki/Being_Mortal#:~:text=3.2%20Film-,Description,treat%20patients%20approaching%20their%20ends.
(3.) Palliative Care Training Expands to More Providers to Improve End of Life Care. https://stanfordhealthcare.org/health-care-professionals/medical-staff/medstaff-update/2016-december/palliative-care-training-expands-to-more-providers-to-improve-en.html
(4.) More Medical Schools investing in Palliative Care Education. Holley Vessel. September 21, 2022. https://hospicenews.com/2022/09/21/more-medical-schools-investing-in-palliative-care-education/
(5.) World Hospice and Palliative Care Day Raises Global Awareness. Holly Vossel. October 6, 2022. https://hospicenews.com/2022/10/06/world-hospice-and-palliative-care-day-raises-global-end-of-life-care-awareness/(6.) What is the Silver Tsunami? What an Aging Population Means for California. https://www.caregivercalifornia.org/2022/07/26/what-is-the-silver-tsunami-what-an-aging-population-means-for-california/