Caregiver & Elder Care News
Seniors Want Doctors to Follow End-of-Life Wishes: Gerontological
Advance directives can benefit patients, families, and health care
system; hold doctors accountable
Nov. 4, 2014 - Nearly one out of four senior
Americans say that either they or a family member have experienced
excessive or unwanted medical treatment, according to the latest issue
of The Gerontological Society of America’s
Public Policy & Aging
which goes on to show that Americans strongly support holding doctors
accountable when they fail to honor patients’ end-of-life health care
Illness Care: Issues and Options,” features 12 articles that present
new ways of understanding the complexity of securing appropriate
advanced illness care and the decision-making dilemmas it presents.
It also provides a valuable benefit by reviewing
specific programs, demonstrations, and tools that family members and
providers can use in providing care to persons with advanced illness.
These models are person- and family-centered, and preliminary
evaluations find that they may be cost-effective as well. Support for
the publication was provided by Compassion & Choices.
“It is important to ensure that patients and their
wishes are what drive the health care system, particularly at the end of
life,” said Daniel R. Wilson, the national and federal programs director
for Compassion & Choices.
“We were pleased to partner with The Gerontological
Society of America to publish this issue of the
includes cutting edge writers and thinkers in the advanced illness and
Advanced illness is defined as the period of
illness when functioning and quality of life decline and where the
efficacy of continued treatment is open to both medical and ethical
question. Yet, as illness becomes more debilitating, clinical
interventions often become more frequent. Studies show that the average
Medicare beneficiary with one or more chronic conditions sees eight
different physicians each year.
It is at this stage when the medicalization of
health care tends to overtake and overwhelm the needs and wishes of
patients themselves. Advanced illness, due to disease, chronic
conditions, or disability, can happen to anyone at any age. However, the
vast majority of people with advanced illness are older than 65.
“Recent experience and studies make clear that
well-informed individuals and their families often choose less care, in
less institutional settings, often resulting in improved quality of
life,” state Robert B. Hudson, PhD, and Brian W. Lindberg, MMHS, in
their introduction to the issue.
“It has become clear that palliative
care and hospice care are often not provided soon enough, and that
in-depth conversations with persons with advanced illness can help
articulate treatment and life-style preferences that the health care
system has often ignored or missed.”
Among the discussion of new models and tools that
have been developed in recent years to better address advanced illness
dilemmas and decisions, Charles Sabatino, JD, the director of the
American Bar Association’s Commission on Law and Aging, highlights
more than a dozen resources for updating and codifying preferences.
He lists these under four headings: getting the conversation going,
comprehensive advance planning tools, guides focusing on certain
illnesses or decisions, and advance directive registries.
PP&AR comes on
the heels of a major report released by the Institute of Medicine this
fall, which was titled “Dying in America: Improving Quality and Honoring
Individual Preferences Near the End of Life.” Its findings demonstrated
that improving the quality and availability of medical and social
services for patients and their families could not only enhance quality
of life through the end of life, but may also contribute to a more
sustainable care system.
Public Policy & Aging
Report is a publication of the
National Academy on an Aging Society, the policy branch of
The Gerontological Society of America (GSA). As the nation's oldest
and largest interdisciplinary organization devoted to research,
education, and practice in the field of aging, GSA’s principal mission -
and that of its 5,500+ members - is to advance the study of aging and
disseminate information among scientists, decision makers, and the
general public. GSA’s structure also includes an educational branch, the
Association for Gerontology in Higher Education. Follow GSA on