We all know end-of-life discussions are difficult for families. We recognize National Healthcare Decisions Day to bring awareness to advance care planning and encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be. And the urgency for these end-of-life conversations is sooner rather than later.
Doctors Struggle With End-of-Life Discussions
NPR presents an article that tells the other side of the story: the struggle for the doctors that are caring for older patients. They know it’s important to talk with their patients about end-of-life care, but they’re finding it tough to start those conversations. When they do, they’re not sure what to say, according to a national poll released Thursday.
Such discussions are becoming more important as baby boomers reach their golden years. By 2030, an estimated 72 milllion Americans will be 65 or over, nearly one-fifth of the U.S. population.
Medicare now reimburses doctors $86 to discuss end-of-life care in an office visit that covers topics such as hospice, living wills and do-not-resuscitate orders. Known as “advance care planning,” the conversations can also be held in a hospital.
We Know It’s Our Job
The poll of 736 primary care doctors and specialists, including 202 in California, examined their views on advance care planning and end-of-life conversations with patients. Among the findings:
- While 75 percent of doctors said Medicare reimbursement makes it more likely they’d have advance care planning discussions, only about 14 percent said they had actually billed Medicare for those visits.
- Three quarters also believe it’s their responsibility to initiate end-of-life conversations.
- Fewer than one-third reported any formal training on end-of-life discussions with patients and their families.
- More than half said they had not discussed end-of-life care with their own physicians.
Studies have shown an increasing number of patients and their families want to talk about end-of-life planning. This can ensure the patient gets to die at home instead of the hospital (a wish for many patients) and save money on aggressive medical interventions they don’t want and that won’t prolong life.
What’s the Solution?
The support process for physicians must improve to include end-of-life planning discussions in medical training. You can read the whole NPR article here.
A resource for families to start these conversations with others including doctors comes from the Conversation Project. The Starter Kit will help you get your thoughts together and then have the conversation. This isn’t about filling out Advance Directives or other medical forms. It’s about talking to your loved ones and health care team about what you want for end-of-life care.
Whether you’re getting ready to tell someone what you want, or you want to help someone else get ready to talk, the Starter Kit will be a useful guide.
The Conversation Project works in collaboration with the Institute for Healthcare Improvement, a not-for-profit organization that is a leader in health and health care improvement worldwide.