Tuesday, November 19, 2002


United States is a terrible place to die - study

By Maggie Fox

WASHINGTON, Nov 18 (Reuters) - The United States is a cold and uncaring place to die, offering little relief from pain or even sympathy to people in their last weeks and months, according to a report issued on Monday.

"Dying patients and their families today suffer more than they should," Judith Peres, deputy director of the nonprofit consumer coalition Last Acts, which wrote the report, told a news conference.

"We still have a long way to go to improve health care and policy for this segment of the American population."

Although more than 70 percent of Americans say they would like to die at home, only 25 percent of them do. The rest are often hooked up to machines in intensive care units, the report says.

About half of all deaths occur in hospitals, but fewer than 60 percent of hospitals offer specialized end-of-life services. Only 14 percent offer palliative care, which means special care to make sure a dying person is comfortable without working to extend a doomed life.

Hospitals concentrate on extending a patient's life, even if staff know the patient is dying, the report says. It may be kinder, Last Acts says, to allow the patient to gently slip away in as much comfort as possible.

Just 23 percent of hospitals offer hospice care, which is designed to do just this.

"Most states have only fair hospice use, with about 12 to 25 percent of deaths including a hospice stay," the report says.

Most dying people get only a week in a hospice, when 60 days would be much better, the group found.

And fewer than half, 42 percent, offer specialized pain management services.

"In any given state, at least one in four nursing-home residents is experiencing pain for at least two months without appropriate pain management," the report says

"A study of cancer patients in the ICU found that 55 to 75 percent had moderate to severe pain, discomfort, anxiety, sleep disturbance or unsatisfied hunger or thirst."

A survey of 1,000 adults, done by Lake, Snell Perry and Associates for the group, found that 75 percent had lost a loved on in the past five years. Sixty percent of those surveyed gave the U.S. health care system a rating of fair or lower, and 25 percent said it was poor.

It found that 93 percent believed improving end-of-life care was important.

The report notes that many Americans are reluctant to talk about death and dying, so few people have pushed for better policies.

"We want to create a wake-up call," Peres said. "We want to let policymakers and people in this country know that we need better care for people at the end of their lives."

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