Despite nationwide efforts to improve hospice and palliative care programs, end-of-life care has worsened, according to a Kaiser Health News report on an observational study published by Annals of Internal Medicine.
Dying in America has gotten more painful, with the number of Americans experiencing pain in the last year of life increasing by nearly 12 percent from 1998 to 2010, and depression increasing by more than 26 percent, the study found.
Researchers used qualitative data from 7,204 patients who died while enrolled in the national Health and Retirement study, a survey of Americans over 50 years old. After each member's death, researchers interviewed their family members to determine if they suffered pain, depression or periodic confusion during their last year of life. According to analysis, those three symptoms became more prevalent during the course of the study.
Joanne Lynn, MD, director of the Center for Elder Care and Advanced Illness at the Ann Arbor-Mich.-based Altarum Institute and author of the study, points to several reasons for worsened end-of-life care.
- Over the course of the study, physicians increasingly used a greater range of high-tech treatments, which can effectively extend a patient's life without providing a cure.
- Research is largely aimed at wiping out diseases and not developing long-term supports or symptom management for people with age-related chronic conditions or disabilities.
- Many physicians tend to under-treat for pain and other symptoms at the end of life because they don't recognize them or are apprehensive about discussing the process and pain associated with dying.