We’re all familiar with the very real issue of health disparities when it comes to receiving care throughout the United States. Those disparities also extend to the final days of life, according to a new study in JAMA Internal Medicine.
The National Hospice and Palliative Care Organization (NHPCO) estimates that 1.6 million to 1.7 million people received hospice care in 2014. The study noted that in the last two days of life — a time when symptoms are often intensified and families need additional support — visits by professional staff varied widely depending on race, day of the week and geographic location. Continue reading
It’s been some month. With so many high-profile deaths reported this January — David Bowie, Eagles co-founder Glenn Frey, Dan Haggerty of Grizzly Adams, the husband and the brother of singer Celine Dion, Mott the Hoople’s Dale Griffin – it’s enough to give you the shivers.
We know about these deaths because they’re high-profile celebrities and rock icons.We don’t generally know about the thousands of other, less-famous people who also died this month from cancer, Alzheimer’s disease, complications from multiple chronic conditions or other causes. With the world paying attention — in part thanks to Bowie’s final gift of “Blackstar” – it’s an opportunity to extend the discussion surrounding palliative care, hospice and how we want to die. Continue reading
While end-of-life planning may be more common by providers and patients, there are “substantial” racial disparities when it comes to hospice use among some older adults, according to a new study. Researchers found that end-stage renal disease (ESRD) patients who were African American or Native American were 44 percent less likely to take use hospice care than white patients. Asian-Americans were 43 percent less likely to do so. Continue reading
A well-known, prominent California physician. Allegations of a suspicious death. Family feuds. A recovering addict and possible affair. Elder abuse. A controversial investigation by the coroner.
While it may sound like a made-for-TV movie or the latest John Grisham novel, this life-and-death true story took journalist Charles Piller more than 10 months to investigate. Not only did Piller track and verify conflicting accounts of Jerome Lackner’s final months, but he also had to somehow navigate privacy roadblocks thrown up by hospitals, providers, the hospice facility and lawyers.
In this fascinating “How I did it,” Piller describes his five-part Sacramento Bee investigative series that may raise as many questions as it answers. He explains his efforts to answer basic questions about the roles and responsibilities of caregivers, hospitals, and hospices, and how he had to unravel a web of finger pointing by family, ex-spouses, friends and health professionals.
Without seeming to take sides, how does a reporter sift through mounds of conflicting evidence to create an engaging and coherent narrative? How can you track down reluctant key players in such a saga? How do you separate fact from fiction when family members accuse caregivers of indifference, neglect – or worse? Read about how Piller did it when investigating the death of Dr. Jerome Lackner.
Hospice use is a common indicator of quality end-of-life care. The timing of hospice enrollment is an important component of that care, and a recent study finds wide variations among states.
Researchers from Yale University compared 2011 hospice use data on a state-by-state basis of 660,000 Medicare patients during the last six months of their lives. They identified several key trends among states in the rates of very short or very long hospice stays (reflecting late or early enrollment) and of patients leaving hospice before their deaths. Continue reading
Nancy Berlinger, Ph.D., is a research scholar at The Hastings Center and co-author of a retrospective article on palliative and end-of-life care that was published in the Feb. 12 New England Journal of Medicine.
In part one of our conversation, Berlinger focused on the need to broaden the discussion among and improve training of clinicians on talking to patients about end of life issues. In part two, she discusses foreseeable scenarios, societal perspectives and how to improve media coverage of this complex topic. Continue reading