Making End-Of-Life Wishes Known Is Rare; More Hospice Care Could Save Medicare Money

The Associated Press reports on hospice care. "Lillian Landry always said she wasn't afraid to die. So when death came last week, the 99-year-old was lying peacefully in a hospice with no needles or tubes. Her final days saw her closest friend at her side and included occasional shots of her favorite whiskey, Canadian Mist. Landry is an exception. Unlike most Americans, she made her end-of-life decisions years ago: no heroic measures to save her ... The health overhaul bill that narrowly passed the House on Saturday includes a provision to nudge more people to confront such choices: It would pay for end-of-life counseling for Medicare patients."

Because Medicare beneficiaries account "for the vast majority of U.S. deaths" the treatment people receive "in the last year of life accounts for roughly a quarter of Medicare's budget." Dr. Joel Policzer, a medical director for a hospice, says that often "a dying elderly patient may have wanted less invasive care. But it doesn't happen. 'It doesn't happen because people are never asked. If they were, people would tell you they want to die at home in bed, surrounded by their family, their friends and their pets,' he said" (Sedensky, 11/11).

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