What Do We Owe the Dying Strategies to Strengthen End-of-Life Care - Case Study Example

? What do we owe the dying? Strategies to strengthen end-of-life care What do we owe the dying? Strategies to strengthen end-of-life care  Background There is rising demand for inpatient hospital care for patients who have been diagnosed with fatal illnesses. Thousands of Americans die each year in an inpatient hospital setting. With such a high percentage of aging population in our country, it is evident that the demand for EOL care is increasing. Organizations like Institute of Medicine have suggested that there should be an extension for EOL care services. There are several ways to improve the services for the patients and make the treatment more cost effective. Introduction and Analysis Majority Americans die in hospitals in very critical conditions. It is believed that the more health facilities an ill person gets he is likely to recover from the sickness faster, but this is not the case with old age patients who are nearing the end of their life. With an intake of a lot of drugs their health worsens and it diminishes their quality of life during this period and also the quality of their death. National surveys reveal that about 80% of Americans die in hospitals or other institutions although the mainstream chooses to die at home. It is astonishing to know that one third of the Medicare spending which make up around 144 billion dollars is spent on patients who are nearing the end of their life. Also very few hospitals in America give palliative care to their patients which can help them to make a decision about the end of their life. There is a lack of proper end of life planning in America and many patients believe that they do not die a “reverential death”. Patients nearing the end of life have to face disturbing situations where they are required to make yes or no decisions around which their lives revolve. For example sometimes they are stuck in pressures from their family members, they have continuous persuasion from the doctors who are trained to make the patient hopeful and in this way can suggest heavy dosage of medicines as well. Moreover they have to decide upon how to maintain their life during their last days and should they opt out for severe medical treatments that might be very much painful for them. The modern health care system has huge costs and the amount of money spent on end of life treatment is very expensive. It becomes a burden for the old age patients. The SUPPORT study which is the biggest research project investigating end of life care treatment, disclosed that many people in stress of the expensive treatment, in pain and suffering and also because of loneliness. A U.S. Institute of Medicine‘s research revealed “people have come to both fear a technologically over-treated and protracted death and dread the prospect of abandonment and untreated physical and emotional stress.” Analysis and Application There are two main institutions that provide funds for end of life care treatment in America. One is Medicare which is a social insurance program for the old age citizens and disabled population. It is funded completely by the federal system and they collect money through general revenues, payroll taxes and from volunteers. It is the principal insurance service in the United States for more than 80% people who die. Facilities for patients towards the end of their life constitute 28% of Medicare expenditures; this number has remained stable for the past twenty years. The other is Medicaid which is the health care program by the state for the low income group. It includes parents, children, old age people and disabled people with low incomes. It is the chief institute funding for long term healthcare. There are private insurance companies as well but they facilitate the younger people with their health care benefits and the young population mostly stays healthy. Both Medicare and Medicaid play a major role in providing funds for end of life care treatment but they follow the traditional hospice benefit system. The services which include medical, social, psychological, spiritual are mostly provided at the homes of the patients with minimal services at the institution. Resolution Healthcare organizations should develop and expand their end of life care services through various means by providing end of life education, setting up hospitals for end of life services and facilities and by getting support from the community. The education services should cater to the patients and their families as well. They expand awareness about healthcare and end of life care and also educate patients when they were being admitted as in patients in the institute. Through the education program they hold counseling sessions and organize public education programs on concerns like diabetes, parental care, etc. In the hospitals there should be separate beds and hospitals for the patients of palliative care. Hospitals should also relax their visiting times for the visitors who come to see patients who are about to die. Moreover the environment of the hospitals rooms and their surroundings should also be improved by putting up colorful and positive pictures and setting up comfortable furniture so that the patients and visitors feel at home. With increasing old age population, there comes a huge burden on the healthcare service providers to offer efficient and adequate facilities for the patients who need end of life care. The services are likely to be successful when the programs are properly managed and planned. However many programs tend to focus on reducing the length of the dying process by giving life prolonging treatment. While administering this, they give secondary importance to the physical pain and how to lessen it. It is imperative for everyone to know that we owe a good healthy life to the end of life patients. For this their care should focus on good pain reducing and management techniques. Moreover the treatment should be done after consultation from the patient about the dosage of the medicines and for how long should they be given. Hence the foremost responsibility lies on the healthcare system that needs to improvise the facilities and manage the end of life care in their institutions so that the patients die a ‘dignified death’ Read More