This article features an interesting report on end of life care in the US. This is particularly relevant to the LTC community at all levels of care. While many equate palliative care with hospice, the report draws a distinction. Palliative care is an interdisciplinary process that applies symptom control modalities to anyone with chronic ailments, while hospice is a particular benefit geared towards people with terminal disease.

The report highlights the work of Aetna, under the leadership of Jack Rowe MD, a prominent geriatrician who served as its CEO from 2004-2007, showing the need to provide palliative care in conjunction with curative care. This applies to nursing homes and many of our community dwelling elders. These are people with multiple chronic diseases with disabling symptoms such as pain or respiratory difficulties. These individuals need help controlling their symptoms and managing their diseases, but have historically been faced with needing to make the "terrible choice” between curative care or Hospice. They also need help in articulating their goals of care that will guide their future care. They need thoughtful and sensitive clinicians to help execute advance care planning documents. I think that the advent of ACA, increased consciousness for quality of care, patient satisfaction as well as cost saving, provides the "perfect storm" to make a change and allow palliative care to coexist with curative care. That may mean some changes in how we approach it and how it is paid for.

Click here for the paper:

A Better Benefit: Health Plans Try New Approaches to End-of-Life Care

Want to comment or discuss this article?  Login to the new CALTCM Blog.