What You Should Know About End of Life Care
By Cameron Muir, MD, Chief Medical Officer
One of the comments we hear most frequently from families with patients facing a serious, life-limiting illness is, “I wish I had known about you sooner.”
There are so many misconceptions around hospice and palliative care that prevents those suffering with physical pain and emotional distress, as well as those family members who are caretakers and the primary support systems from experiencing enjoying the many benefits available to them.
Capital Caring is the largest and most experienced nonprofit hospice and palliative care provider in the mid-Atlantic region. We have been providing physical, emotional, and spiritual support to thousands of patients and families over our forty-year history, and are actively engaged in public education and advocacy to raise awareness of the many benefits of hospice and palliative care and dispel perceptions that such care is only meant for the final days of life.
The following are some important facts that may help you understand the value of hospice and palliative care.
- Hospice is covered under Medicare, Medicaid, most private insurance plans, HMOs and other managed care organizations. Hospice is a paid benefit for all Medicare beneficiaries and is intended to cover end-of-life care for up to six months.
- Currently, most hospice patients have their costs covered by Medicare through the
Medicare Hospice Benefit. The Medicare Hospice Benefit was legislated in 1982 to provide advanced illness care for patients with life-limiting conditions.
- Hospice includes a full-range of health care and social support benefits at no cost to the patient or their family. The majority of hospice care is provided in the place the patient calls home. (private residence, nursing home and residential facilities).
- Of the approximately 2 million people who die each year, between 1.4 – 1.5 million receive at least one day of hospice care. However, only a very small portion of the total hospice eligible days are utilized by Medicare beneficiaries in the last year of life. Medical professionals and other referral sources often wait longer than necessary to talk with families about quality of life options, and consumer awareness of the benefits remains limited.
- Research shows that 8 out of 10 Americans would want to stay in their homes surrounded by family and loved ones if they were faced with a life-limiting illness. Despite their wishes, most patients still die in hospitals where they absolutely do not want to be during their final days. This adds great emotional, physical and financial burden on patients and families. Much of this burden can be prevented with timely hospice care.
- On average, each day spent in an acute care hospital bed costs more than 10 days of high quality hospice care And a day in an intensive care unit (ICU) usually costs much more than a full month of hospice care.
- The median length of service for hospice patients is 17.4 days (half of patients receive care for more days, half of patients receive care for fewer days). Yet, more than 35 percent of patients die or are discharged in seven days or less – too short a time to benefit from the full ranges of services a hospice can offer.
- Earlier engagement, exploration of options and planning equate to demonstrably superior end-of-life experiences for patients and their families.
- In 2015, cancer accounted for 27.7% percent of hospice patients. The other leading
diagnoses are: cardiac and circulatory diseases (including stroke), dementia, and respiratory, kidney and liver disorders.
- More than half of the Medicare beneficiaries who take advantage of the hospice benefit are female (58.7%) and about two-thirds are 80 years of age or older, reflecting our longerliving Medicare population.
- An estimated 430,000 trained volunteers contribute more than 19 million hours of service every year.
Cameron Muir, MD, Executive Vice President, Quality and Access and Chief Medical Officer J.
Cameron Muir, MD, FAAHPM, is a nationally recognized expert in palliative care and hospice. Prior to his work with Capital Caring, Dr. Muir was Medical Director of the Palliative Care and Home Hospice Program of Northwestern Memorial Hospital. He served as the Director of the Palliative Care Program of the Northwestern University Medical School. Dr. Muir is Board-Certified in Hospice and Palliative Medicine and Internal Medicine. Dr. Muir received his medical degree from the University of Virginia School of Medicine, completed his residency in internal medicine at Dartmouth-Hitchcock, and earned fellowships in bioethics at the University of Chicago Medical Center and in Hospice and Palliative Medicine at Northwestern University Feinberg School of Medicine.