As a result of advances in public health and the development of lifesaving medical technology, Americans live longer than ever. Death, when it comes, often follows a chronic or progressive illness.
Unfortunately, the care received near the end of life often does not reflect a person’s values, goals, and informed preferences. Although the majority of people say they would prefer to die at home, two-thirds of Medicare beneficiaries die elsewhere, such as a hospital’s intensive care unit. People frequently endure unwanted treatment and suffer from inadequate pain management and shortness of breath, which often puts an enormous stress on family caregivers. A fragmented medical system and a lack of communication among doctors, patients, and families may result in less than optimal patient experience. But difficulties in the health care system may also be caused by the reluctance of patients, families, and doctors to discuss options and the alternatives to further treatment. Having these conversations early in the course of a serious illness is important, because most people who are near death are unable to communicate their wishes.
Pew seeks to improve end-of-life care by advocating for policies that help people make informed decisions about their treatment preferences, improve the documentation of these preferences, and hold health care providers accountable for honoring patient wishes and delivering high-quality care. Additionally, the project will highlight innovative ways of providing care to seriously ill people and their families as the patients reach the end of their lives.
The Pew Charitable Trusts today announced its support for the Patient Choice and Quality Care Act, introduced by Senators Johnny Isakson (R-GA) and Mark Warner (D-VA), and Representatives Phil Roe (R-TN) and Earl Blumenauer (D-OR). This bipartisan, bicameral legislation contains provisions designed to help people make informed decisions about the types of medical care they want near the end of... Read More
The US health care system is not delivering the care that patients with serious illness need and want. For example, although most people say they would like to die at home, nearly 70 percent die in nursing homes, intensive care units, or other medical settings. Given that approximately 70 percent of people who die in the United States each year are Medicare beneficiaries, the new administration... Read More
The Pew Charitable Trusts and the Gordon and Betty Moore Foundation, with support from Discern Health, wrote a letter March 14 to Health and Human Services Secretary Tom Price and Seema Verma, the newly confirmed administrator of the Centers for Medicare & Medicaid Services, outlining a number of steps that Medicare could take to ensure that patients and their families receive high-quality... Read More