End of Life Care: When is enough, enough?

Anyone who’s ever dealt with the terminal illness of a loved one understands the emotional, physical, and often financial stress a family takes on during an exceedingly difficult time. Tough decisions must be made by all, but are these choices really in the best interest of the family, or the dying person?

Shockingly, 1/4 of all Medicare dollars are spent on only 5% of those beneficiaries who are in their last year of life. This amounts to over $125 billion. One study conducted by Dr. Jonathan Bergman of UCLA estimated that 1/3 of total lifetime health care costs are spent in the last year of a person’s life.  People nearing their final days often spend their entire life savings on medical care, and family members can be left with hefty bills after their loved one is deceased.

Cost of end of life care

Heroic measures are often taken to prolong the lives of people in likely terminal situations. There are several reasons as to why this occurs. Many doctors have difficulty relating exactly how dire the prognoses for their patients really are to their loved ones. They offer expensive treatments that often have little chance of actually working.  These aggressive life prolonging measures are not only expensive, but they may also lessen the quality of life for the remainder of the time the person has left. Family members also understandably tend to struggle with letting go when they are told there may be some hope for a loved one to hang on a bit longer.

Proposed solutions to this complicated issue include signing an advanced directive before crises occur; making one’s wishes known about what life saving measures one would or would not prefer to take place. (In some hospitals, however, these have been ignored.) Furthermore, although surveys have proven that most Americans would prefer to die at home, about 75% of them die in hospitals or nursing homes. Hospice offers a more cost effective and often more comfortable alternative with a better quality of life for its populace.

As millions of baby boomers begin to reach retirement age, and head toward their elderly years, this problem may get worse before it gets better. So what do you think? Is it important how healthcare dollars are spent on this delicate issue, or should lives be prolonged at any cost?