Despite the fact that the U.S. has made significant investments in hospice and palliative care in recent decades, the last years of people's lives appear to be getting less bearable.
The recent findings reveal a significant decrease in quality of life seen in this type of care, the Altarum Institute reported.
Researchers looked at the Health and Retirement Study, which looked at the family members of individuals who had died between the years of 1998 and 2010. They found pain affected 54 percent of the patients who passed in 1998, and 61 percent in 2010. The increase was consistent in individuals dying from heart failure, chronic lung disease, and frailty from old age, but was not seen in cancer patients. The researchers also observed increases in "depression, periodic confusion, shortness of breath, incontinence, fatigue, lack of appetite, and anorexia."
"The symptom burden of people nearing the end of life is quite substantial and, at least from the family's perspective, is worsening," lead author Adam Singer said. "This may be because dying people are living longer in very fragile health, more medical interventions are being used, or... family members have higher expectations."
The use of hospice care doubled between 2000 and 2009 and palliative care has only recently been established in many hospitals.
"The overall trend is alarming, and these findings call for serious and thoughtful response," said Dr. Joanne Lynn, co-author and director of the Center for Elder Care and Advanced Illness at Altarum Institute. "The country has invested a great deal in better end-of-life care, yet we are losing ground. Every person wants to be confident that he or she will live as meaningfully and comfortably as possible through to the end of life; however, what awaits us toward the end is a very difficult passage. Health care managers and clinicians need to build on what works and to learn a great deal more about how to arrange supportive and palliative services so that it is safe to come to the last part of life. The public should demand better performance."
The findings were published in a recent edition of the Annals of Internal Medicine.
