Ann Arbor, MI — Americans express strong views when asked about the care that they want to receive when they are dying. In general, they prefer to die at home and to remain in charge of decisions about their care. However, evidence suggests these wishes are not likely to be fulfilled.
Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, a new report from the Institute of Medicine, examines the delivery of health care, social services, and other support to individuals of all ages with a serious illness or medical condition who may be approaching death, as well as their families. In addition, the report assesses advance care planning; health care costs, financing, and reimbursements; and communication among patients, family members, and providers.
The report offers recommendations for changes in policy, financing mechanisms and payment practices, workforce developments, research, and clinical and supportive care. The recommendations presented focus specifically on those with “a serious illness or medical condition who may be approaching death.”
The committee overseeing this report, which includes Judy Peres, Senior Policy Analyst at Altarum’s Center for Elder Care and Advanced Illness, offers five recommendations in the areas of care delivery; clinician-patient communication and advance care planning; professional education and development; policies and payment systems; and public education and engagement, which collectively offer a roadmap for progress in the nation’s approach to end-of-life care and management.
Specifically, the committee recommends the following:
“The steps outlined in this report represent a clear challenge to redesign and reallocate the system and benefits to allow people near the end of life to receive social services that help them remain at home or in the community, which is where many prefer to be,” said Peres. “Harmonizing medical and social services for people and their families near the end of life helps eliminate provider incentives to shift dollars [and] ensures people receive care in the right setting at the right time in accordance with their informed preferences and values.”
To obtain a copy of the report, contact the National Academies’ Office of News and Public Information at 202-334-2138 or firstname.lastname@example.org.
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