New Jersey hospital looks to make life easier for terminally ill patients

Every day, terminally ill patients flood emergency rooms.

They often receive invasive treatments, even if they only have months or weeks left to live.

These therapies can be dangerous and costly.

Patients spend 40% of their Medicare expenses in their last month of life.

Now, one hospital is trying to remedy the problem by combining two fields of medicine.

Mattie McDowel is planning for something most people do not like to think about: her death. She has stage-four breast cancer and not a lot of time left.

She says, "They said it's not curable. When they found it was cancer, I lied there, praying to die every day. I just didn't want to be a burden on anyone."

She wants to spend her last days at home and not in the hospital. Dr. Mark Rosenberg says 70% of people die in a healthcare setting.

However, Dr. Rosenberg says, "If you ask 100 people, 100% of them will tell you they don't want to die in the hospital."

Dr. Rosenberg heads one of the country's only palliative care programs that operates out of the hospital's emergency room. Palliative care is specialized medical care focused on providing patients with relief from the symptoms, pain, and stress of a serious illness.

"Doctors sometimes tend to make a textbook decision for you, but if you say what would you do for your mom, you may get a whole different answer."

Instead of repeat trips to the emergency room or extended hospital stays, the team helps these terminal patients find ways to stay home. The Institute of Medicine estimates that if palliative care was fully integrated into US hospitals, healthcare spending could be reduced by $6 billion a year!

A recent study also found those who receive this type of care report less depression, pain, nausea, and worry, and they survived 2.7 months longer.

As for Mattie, she wants to spend her last days at home with her loved ones.

The hospital in this story is in Patterson, New Jersey.

Hospice care often works in conjunction with palliative care.

Hospice focuses on caring for a patient in a person's home.

Care is also provided in freestanding hospice centers, hospitals, and nursing homes.

Palliative care extends the principles of hospice care to a broader population that could benefit from receiving this type of care earlier in their illness or disease process.

RESEARCH SUMMARY

BACKGROUND: In 2008 the average cost of an ER visit was approximately $1200 compared to the average cost of a doctor's office visit at only $199. Most health insurance plans cover a portion of the costs of an emergency room visit and these visits are not limited over the course of a year. However, with prices like these health insurance premiums may go up if insurance companies notice a pattern of going to the ER instead of a general practitioner, most hospitals recommend avoiding the emergency room if possible. They recommend only going to the ER when you have an emergency that you cannot solve on your own and leave the ER for those who are in a real emergency. If you are unsure about your condition it is a good idea to call the ER ahead of time to speak with a nurse. If you have a serious condition the ER is the best place to go for treatment. (Source: www.cdc.gov)

PALLIATIVE CARE CENTERS: Due to the high number of terminally ill and long-term illness patients a new alternative to ER care has emerged in some hospital. Palliative care is specialized medical care for people with serious illnesses. Palliative Care Centers focus on providing patients with relief from the symptoms, pain, and stress of a serious illness. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient's other doctors to provide an extra layer of support for patients suffering from a variety of diseases as well as those with terminal illnesses. Palliative care is offered for patients at any age and at any stage in a serious illness and can be provided along with curative treatment. To get palliative care you must have a doctor referral.
(Source: www.getpalliativecare.org)

Hospice care often works in conjunction with palliative care. Hospice focuses on caring for a patient in a person's home. Care is also provided in freestanding hospice centers, hospitals and nursing homes. Palliative care extends the principles of hospice care to a broader population that could benefit from receiving this type of care earlier in their illness or disease process.

BENEFITS OF OFFERING PALLIATIVE CARE OUT OF THE EMERGENCY ROOM:
In 2010, the Institution of Medicine estimates health care spending would be reduced by $6 billion a year by reducing healthcare usage. Meaning patients do not undergo costly procedures that are common to those who go into the emergency room during their final stages of a serious illness (Source: New England Journal of Medicine).

DOWN FALLS OF OFFERING PALLIATIVE CARE OUT OF THE EMERGENCY ROOM:
* Not enough certified employees in both palliative care and ER. A study found that only about 86 palliative care fellows are trained each year, which is too few to meet the needs of the aging baby boomer population (Source: capc.org). Dr. Rosenberg M.D. of St. Joseph's Regional Medical Center said, "There are only 34 physicians in the country that are board-certified in both palliative care and Emergency Medicine."
* Medicare does not pay teaching hospitals to train doctors in palliative care. Medicare offers to pay for the patient's need, but does not pay hospitals to train doctors in this field (Source: capc.org).


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