Care for chronically ill and very sick patients is historically costly and sometimes inexorably linked to unnecessary procedures. Physicians of ten struggle over the question of how much care is appropriate under the circumstances: Should there be another test done? Should there be another surgery?
It's never easy, and of course, it's wrapped around a series of complex issues, among them the wishes of the patients and family and the ethical decision for each case.
Through it all, physicians want to help patients, who are often seeking "a mix of cure and comfort," in the words of Brad Stuart, MD, CMO, Sutter Care at Home, the homecare and hospice provider based in Northern California near San Francisco.
That task may be difficult, at best. Inevitably, healthcare executives often rely on implementing palliative and hospice care to improve quality of life for chronically ill patients, or those nearing death. More hospitals are developing such programs, and the need may be greater in the years ahead, considering the growth of the U.S.'s aging population. By 2030, the number of people in this country over the age of 85, for instance, is expected to double to 8.5 million.
Palliative care is growing in popularity with its multidisciplinary teams who work to care for patients in efforts to relieve suffering, pain, and even the depression and stress that often accompany chronic illness.
And although palliative care is growing, experts in the field are still struggling to define precisely what it is. They are dealing with what they call "image" or "branding" problems, especially as it relates to hospice for patients who are very sick or dying.