Researchers have identified physicians’ familiarity with palliative or hospice care personnel or through their patients as key. Another critical factor, of course, is receptivity to difficult conversations and palliative approaches by the patients and families themselves. The study was published in Palliative Medicine and Health Affairs.

Hospice Care

With luminaries like these passing in days and the median length of stay in hospice just a little over three weeks, the public could be forgiven for thinking that “hospice is where you go to die.” There are outliers, of course, Joey Feek’s exquisitely documented four months in hospice seems like an eternity.

Palliative Service

And then there was Art Buchwald, who famously “failed” hospice after a 5-month stay he called “the best time of [his] life” during which he continued to write a weekly column, entertained friends, and wrote a book, finally dying of kidney failure months later. But somehow these stories sink, and the notion that hospice and, increasingly, palliative care is nearly a drive-by service gets reinforced.

For decades, hospice and palliative care providers have struggled against this narrative, trying to reframe “nothing more we can do” as “living as well as you can for as long as you can” or “comfort care only” as “the best care possible.” Too often, we all hear instead, “Palliative? You mean hospice, don’t you?” and “Hospice? That’s where they pump you full of morphine, and you die.”

Serious Illness

Palliative care is person-centered care designed to anticipate, prevent and manage to suffer for patients with serious illness, from the time of diagnosis onward, alongside curative treatment. Hospice is a type of palliative care available to people with a life expectancy of six months or less, who are no longer seeking treatment.

Emergency Medicine Practitioners

A study found that “family and internal medicine practitioners were twice as likely to refer frequently than were specialty and emergency medicine practitioners, and those who reported comfort with end-of-life care discussions were five times as likely to refer frequently than those who did not.”

These studies and many others recommend education, education, and more education of providers and the public as at least one part of the answer to more timely access to palliative care. 

If enacted, PCHETA promises to make available $49 million a year for four years in grants and contracts to support palliative care and hospice education in pre-professional schools, residencies and fellowships, and continuing education settings, as well as creating a national public awareness campaign and directing additional NIH funds toward palliative care research. This could be a game-changer for palliative care education.