There are two Interesting articles in today’s Economist magazine (economist.com) that report on the “huge gap between what people want from end-of-life care and what they are likely.” This gap was found in a survey done by The Economist in partnership with the Kaiser Family Foundation. For the survey, people in the US, Brazil, Italy and Japan were asked a set of questions about dying and end-of-life care.
Here’s a link to the first article, which is actually a short editorial by the magazine:
www.economist.com/news/leaders
End-of-life care
How to have a better death
Death is inevitable. A bad death is not
Economist, Print edition
Apr 29th 2017
It cites two statistics:
* Nearly a third of Americans who die after 65 will have spent time in an intensive-care unit in their final three months of life.
* Almost a fifth undergo surgery in their last month.
Here’s a link to the second article:
End-of-life care
A better way to care for the dying
How the medical profession is starting to move beyond fighting death to easing it
Economist International Edition
Apr 29th 2017
The second article, titled “A better way to care for the dying,” addresses what Atul Gawande, MD, calls “the experiment of making mortality a medical experience.” It cites a few statistics:
* People in rich countries can spend eight to ten years seriously ill at the end of life.
* Many deaths are preceded by a surge of treatment, often pointless. Nearly a third of elderly Americans undergo surgery during their final year; 8% do so in their last week.
* By 2020, 40% of Americans are expected to die alone in nursing homes.
* One international review of prognoses of patients who die within two months suggests that seriously ill people live on average little more than half as long as their doctors suggested they would. Another study found that, for patients who died within four weeks of receiving a prognosis, doctors had predicted the date to within a week in just a quarter of cases. Mostly, they had erred on the side of optimism.
* Remarkably, in three trials the patients receiving palliative care lived longer, even though the quantity of conventional treatment they opted to receive was lower.
* In one study just 43% of people who had written living wills wanted the same treatment course two years later.
Both articles are worth reading.