Does Where You Live Determine How You Die?

Residents of the state of Oregon are more likely to have their end-of-life wishes honored than residents in the rest of the country, suggests a study in the New England Journal of Medicine. As reported by Kaiser Health News, the analysis indicates that Americans who want to ensure they have a say in how they die should examine the lessons of Oregon.

Key Findings

• Medical professionals and political leaders in Oregon have succeeded in integrating awareness of end-of-life care at all levels, from state government and emergency care to individual decisions made by patients and their doctors.
• As a result, nearly two-thirds of Oregonians who died in 2013 did so at home
• Families and patients outside of Oregon must be vigilant to ensure they receive the care they want. Information, state-specific legal forms and other tools for consumers are available on the Internet. Try:

Hospice Can Help People Get the Care They Want

Timelier enrollment in hospice can help people nearing the end of life get the care they want.

• Patients with the benefit of hospice for a meaningful amount of time are given every chance to make their wishes known and have them carried out.
• Interdisciplinary hospice teams have a more intimate relationship with their patients and work with the goal of ensuring their patients live the way they wish until they die.

“We spend a lot of effort and energy trying to understand patients’ wishes and values at the end of life, and making those wishes and values the focus of the patient’s plan of care,” says Joseph Shega, MD, National Medical Director for VITAS Healthcare. “We do this through good communication and interdisciplinary, person-centered care. VITAS is agnostic to the tool the patient uses.”

Making End-of-Life Decisions Known

It is always preferable when a patient has made end-of-life decisions in advance, as with documented advance directives. When such decisions comply with state regulations, care providers know the patient and family have put considerable effort into them.

But it is what happens in those last months or weeks between the patient, the family and the hospice team that determines how a patient’s wishes are carried out. Referring patients to hospice when they still have months to make the most of the hospice team and the services it provides can help to assure that those wishes are fully met.