Research Published by American Geriatric Society Suggests People Begin Hospice Too Late

New research published in the current issue of the Journal of the American Geriatrics Society states that individuals who access hospice care often do so too late to fully benefit from this holistic model of care. National Hospice and Palliative Care Organization, the oldest and largest leadership organization working on behalf of hospice and palliative care providers applauds the research and attention it brings to issues involving when to best access hospice care.

A team of researchers from the Yale University School of Medicine looked at hospice enrollment for decedents from a cohort of 754 persons aged 70 and older who were enrolled in a larger longitudinal study.  Of the 562 patients who died during the study, more than 40 percent utilized hospice care in the last year of life; however, the median time spent under the care of hospice was less than two weeks.

Study researchers wrote, "In summary, hospice services appear to be suitably targeted to older persons with the greatest needs at the end of life, although the short duration of hospice suggests that additional strategies are needed to better address the high burden of distressing symptoms and disability at the end of life.

NHPCO’s current Facts and Figures Report indicates that 34.5 percent of patients died or were discharged within seven days of admission. In fact, the report shows that 61.5 percent of patients received care for 29 days or less, which may prevent patients and family caregivers from taking full advantage of the full range of services that the hospice team can offer.

NHPCO stresses that hospice care is best suited for the final months of life, not just the final days.

Hospice is more than pain relief and symptom control. Hospice also provides emotional and spiritual support, training for family caregivers, and bereavement services to family for a year following the death of a loved one under hospice care.

Remarked Edo Banach, president and CEO of National Hospice and Palliative Care Organization, "Hospice and palliative care professionals have long known the importance of earlier access to the high-quality, interdisciplinary care that hospice makes available to those facing life-limiting illness.”

“Helping the public and the broader health care community – particularly physicians caring for patients with a non-cancer diagnosis – understand the many benefits of timely access to hospice care is an ongoing initiative at NHPCO. This study will certainly help raise important awareness and we offer our appreciation to the researches who have shared this important work,” Banach added.

Previous research has found that earlier access to hospice and palliative care services can prevent emergency department visits, hospitalizations, and stays in the intensive care unit – all of which can be distressing for those coping with serious and life-limiting illness.

Additionally, hospice works to help patients stay in the home if possible, which is the place that eight out of ten Americans would prefer to be at the end of life.

Timely access to hospice care can increase quality of life for patients and family caregivers. NHPCO suggests discussions of hospice care should take place earlier in the course of a serious illness, before hospice care might be necessary.

“Individuals must also ask their medical professions about hospice care and whether it’s appropriate and when the best time to think about accessing services should be,” explained Banach. “A question people can ask their physicians is: ‘Would you be surprised if I were to die within six months?’ – if the physician feels that this is a possibility, then a discussion about hospice should begin immediately.”

Resources to help people learn about hospice care are available on NHPCO’s CaringInfo.org website and via information, videos and tools from NHPCO’s public engagement campaign, Moments of Life: Made Possible by Hospice, at momentsoflife.org.