Author Interviews, End of Life Care, JAMA / 17.12.2013
Hospice Care: Discussed Earlier by Physicians Who Would Enroll Themselves if Terminally Ill
MedicalResearch.com Interview with:
Garrett M. Chinn, MD, MS
Division of General Medicine, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston
MedicalResearch.com: What are the main findings of this study:
Dr. Chinn: Despite the desire of most Americans facing terminal illness to spend their remaining time at home, only 24% of those aged 65 and older do so. Many spend their final days in an institutional setting such as an acute care hospital, often receiving aggressive care.
In the case of patients facing stage 4 lung cancer, many who would prefer to emphasize pain relief over extending life report not having discussed hospice with a physician. More than 25% indicate that they had not addressed advanced care directives such as do-not-resuscitate orders with their doctors but wanted to do so. This tells us that patients wish to better understand their illness and prognosis and might be interested in learning about hospice. And although the general trend for hospice utilization has increased over the past decade, a high percentage of hospice enrollment occurs quite late in the course of illness, often during an acute hospitalization.
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