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Elderly often drag their feet on having ‘The Conversation’ with families, doctors

Posted June 25, 2018

Posted in NJ.com, written by The Times of Trenton Editorial Board

Like most Americans, you probably hope that when your time is up, you’ll die peacefully in your home, surrounded by loved ones and far away from beeping hospital machines, invasive treatments and the rigid schedules of hospital routine.

If you live in the Garden State, alas, that vision is far from reality.

Citing a 2018 report, the nonprofit New Jersey Health Care Quality Institute notes that at least one in four deaths in our state takes place in a hospital, the third highest rate in the country.

Along with these somber statistics, the institute offered timely suggestions for better tailoring end-of-life care to meet the wishes of dying patients.

These include creating a statewide database to record and keep residents’ requests readily accessible, providing higher reimbursements for consultations about treatment and palliative care, and offering more robust education on the issue not only to healthcare providers but also to the greater population.

That last one is particularly relevant, since the elderly too often drag their feet about having “The Conversation” with their families, or even with their doctors.

In a 2016 poll the institute conducted with Rutgers University, while six in 10 elderly residents responded that it was important to discuss these matters, the same number admitted they had not done so.

Who can blame them? For too many people, just venturing into these waters can be daunting, bringing the notion of death that much closer.

Moreover, while 99-percent of physicians taking part in a recent national poll said these discussions are necessary, fewer than one-third of them said they had received any formal training on conducting them, and a mere 14-percent said they billed for such a consultation.

The institute urges the state to create a comprehensive plan to include New Jersey’s five medical schools, ensuring that all graduates be grounded in having that all-important talk with dying patients.

Dr. Shereef Elnahal, commissioner of the state Department of Health, notes that the department maintains a website with patient forms and other resources to make end-of-life preferences known.

He also says he hopes to see practices followed by the Villa Marie Claire Hospice in Saddle River introduced in other facilities around the state.

Hospices offer palliative care to terminally ill patients, either at home or in a health-care facility. Their goal is to improve quality of life toward the end of that life, while also supporting family members along the way.

Additionally, a new nonprofit called Goals of Care Coalition of New Jersey is bringing together hospital and long-term care leaders, physician advocates, insurance representatives and others to brainstorm ways to ease patients’ final days.

These are encouraging signs that the state is responding to the needs of a graying population.

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