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Too Many Barriers Deprive Dying Patients of Hospice Care

Helping physicians strategize about discussing a patient's prognosis could help

TUESDAY, March 20 (HealthDay News) -- Only one-third of terminally ill patients in the United States seek hospice care, but removing barriers to talking about such care could allow more patients to use the support earlier in their illness, researchers report in the March 20 issue of the Annals of Internal Medicine.

David J. Casarett, M.D., of the Philadelphia Veterans Affairs Medical Center, and colleagues analyzed ways of discussing hospice admission with patients with limited or uncertain life expectancy, and different attitudes towards seeking treatment or cures. They note that the median hospice stay lasts three weeks, and 10 percent of patients enter hospice care on the last day of their lives.

Barriers to discussing hospice care included a Medicare eligibility requirement that patients have six months to live and give up seeking cures, and patients' and families' aversion to the idea that patients have such limited life expectancy, the researchers found.

"Physicians can overcome many of these challenges by considering indicators of a limited prognosis, framing the hospice discussion in terms of the patient's goals and needs for care, and recommending hospice when they think it is the best option," the authors write.

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