What to Expect from End-of-Life Care

by Emily Guy Birken · 4 comments

Death isn’t a subject that many of us like to think about. But the fact of the matter is that we all must plan for that eventuality, including how we want our final days to play out.

According to Amanda Bennet, author of “The Cost of Hope,” “From the 1970s to the 1990s, one study suggests, the cost of adding a single year of life for an individual over age 65 more than tripled, to $145,000 from $46,800 — and health-care costs have been rising ever since. In 2008, researchers from Stanford and Wharton business schools studied dialysis patients and concluded that the average cost of one ‘quality’ extra year of life was about $129,000.”

These huge costs are often incurred in attempting to prolong a life when death is imminent, inevitable, and in some cases, even desired. After all, the terminally ill are often still suffering from the emotional and physical pain that comes with the underlying disease. And as modern medicine becomes better at sustaining the terminally ill, it may be unnecessarily prolonging the inevitable.

Although the majority of Americans state they’d prefer to die at home, about 75% pass away in a hospital or nursing home. What this means for healthy young Americans is that the decisions about end-of-life care should not be put off.

Here’s what you need to know about end-of-life care, so that you can be prepared to make decisions for yourself and your family members when the time comes.

Living Wills

Living wills, also known as advanced medical directives, state your preferences for what should be done to prolong your life should you be unable to make those decisions for yourself. These documents are an important part of end-of-life planning, because they make it much easier for your family and doctors to determine the best course of action should you be unable to.

Living wills can also help to keep medical costs lower, since many life-prolonging technologies are extraordinarily expensive.

Every individual ought to have both a living will and a conversation with a family member about what kind of life-extending care is preferred. Since living wills can’t predict every possible scenario facing a family in a medical crisis, discussing the issue with a trusted family member or friend will help to make difficult decisions much easier.

In addition, younger individuals should broach this subject with their parents or other elderly relatives, who should also be encouraged to make living wills.

Hospice Care

This type of care is given to terminal patients who have a prognosis of six months of less. The focus is on palliative care and emotional support of both the patient and family. Most patients who enter into hospice care — which can be provided at home or at a hospital or nursing home — are very close to the end. In fact, the median time spent in hospice care is usually measured in days and weeks.

Nearly all hospice care is covered by Medicare and Medicaid, and many insurers also broadly cover hospice services. Some patients are nervous about signing up for hospice, thinking it indicates a loss of hope or that it will hasten death. But hospice is a tool for patients to improve their quality of life, so they can enjoy whatever time remains. In addition, hospice offers a great deal of support to families during a difficult time.

The Bottom Line

Dying with dignity and under your own terms is something everyone should have the opportunity to experience. Planning ahead for this eventuality will save you and your family money, heartache, and stress.

Have you planned your end-of-life care?

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  • Holly Thrifty says:

    Keep in mind that hospice provides SUPPORT and in most cases, not direct care unless you are at a hospice facility. You have to pay for nurses or other care givers on an hourly basis. If the family can’t care for the patient, it’s more cost effective, and Medicare AND insurance will pay for some nursing home care–but not in the home.

    I went through this with my mother and unless we put her in a nursing home, there was no way we could financially afford the same level of care at home.

    The doctors suggested that the family take care of her. My 84 y/o dad couldn’t do it all and the “children” all were the breadwinners in the family. I would have lost my health insurance and job taking all that time off. It’s a horrible trade off, but if I cared for her, I wouldn’t be able to care for my family after died.

    Sounds like an easy choice but it’s not.

  • Jerry says:

    I think long-term care insurance is a necessity these days. We are having more longer lasting and debilitating diseases and we’re living longer. It’s not an extra, unfortunately. I hope this is a wake up call to people to try and live differently and more healthfully while they can.

  • Marbella says:

    I understand that this is a major problem in the U.S., but we in most countries in Europe have it automatically in our free healthcare system. U.S. should switch to the same system and the people had been feeling much better.

    • KT says:

      It sounds good but the Euro is an inch from collapsing due to extensive social programs (including free healthcare) and Great Britain is struggling mightily to reform/support its nationalized health care system. Where is the money going to come from when more people take out than put back into the system?
      When people don’t take responsibility for their own health (and there is no financial incentive to do so when it’s “free”) that type of healthcare system is just not sustainable over the long run.

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