On Tuesday the Institute of Medicine released the results of its comprehensive study, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The 505-page report details the findings of the panel’s 18-month investigation into the state of end-of-life care in our country.
“The bottom line is the health care system is poorly designed to meet the needs of patients near the end of life,” said David M. Walker, a Republican and a former United States comptroller general, who was a chairman of the panel. “The current system is geared towards doing more, more, more, and that system by definition is not necessarily consistent with what patients want, and is also more costly.”
Read the full story: End-of-life care needs sweeping overhaul.
The nonpartisan 21 member panel which conducted the study was appointed by the Institute of Medicine, the independent research arm of the National Academy of Science.
The report calls for sweeping changes, many which could be implemented without new legislation. That is not to say that change will come easy since it will require a change in the way society thinks and talks about death.
The report suggests that the first end-of-life conversation could coincide with a cherished American milestone: getting a driver’s license at 16, the first time a person weighs what it means to be an organ donor. Follow-up conversations with a counselor, nurse or social worker should come at other points early in life, such as turning 18 or getting married. The idea, according to the IOM, is to “help normalize the advance care planning process by starting it early, to identify a health care agent, and to obtain guidance in the event of a rare catastrophic event.”
Read the full story: Why dying in America is harder than it needs to be.
Dying in America presents an important call to action for both society and the medical community. The report outlines a series of recommendations which include:
- Improvements for delivery of care
- Clinician-patient communication
- Professionall education and development
- Policies and payment systems
- Public Education and Engagement
While the report makes it clear that there is a great deal of work to do in order to create an environment where people nearing end-of-life receive optimal care, there is room for optimism.
A substantial body of evidence shows that broad improvements to end-of-life care are within reach. In Dying in America, a consensus report from the Institute of Medicine (IOM), a committee of experts finds that improving the quality and availability of medical and social services for patients and their families could not only enhance quality of life through the end of life, but may also contribute to a more sustainable care system.
It is now up to the medical community, our legislators, industry regulators, and us to continue the work of the committee. We need to keep the conversation going so that we can take the next steps toward improvement in what happens when we face our final days.
