University

03/11/2011

Hospice care is better care -- by any measure

WoodsideHospice Palliative care has proven more cost effective and more care-oriented for seriously ill Medicaid patients.

The Wall Street Journal reports that palliative care saves Medicaid an average of 6,900 per seriously ill patient; research proves that that care is better for mood, affect, and survival. More, research is proving that humanistic methods of care are the source of success;  humanistic psychologist Abraham Maslow’s hierarchy of needs is being used as the foundation patient care and treatment.

Published in the New England Journal of Medicine, the study on palliative care looks at 151 patients with Metastatic Non-Small Cell Lung Cancer, and early palliative care intervention. The patients chosen for the study were randomly assigned to one of two groups; palliative care with standard oncologic care or standard oncologic care alone. At the twelve week mark, the quality of life and mood were assessed in the study participants through a variety of scales and instruments. Based on the data, researchers concluded that quality of life, mood, and affect were significantly greater among patients receiving palliative and standard oncologic care concurrently.

Complimenting this, researchers Zalenski and Raspa from the Department of Emergency Medicine and Palliative Care in Michigan, found statistically significantly results for palliative and hospice care environments when implementing the motivation and needs theories of Abraham Maslow. Researchers clearly adapted the five levels of Maslow’s hierarchy of needs to palliative care environments – including:

1.)    Distressing symptoms of pain and dyspnea

2.)    Working with patient fears regarding physical safety, dying and abandonment.

3.)    Working with: love, acceptance and affection in the face of debilitating illness

4.)    Work with esteem and respect needs in the interior and exterior environments

5.)    Experiences of actualization and transcendence in the face of death and/or serious illness

 

Zalenski and Raspa speak to the success of the research stating, “Maslow’s framework provides a comprehensive approach not only for achieving comfort at end of life—through the relief of symptoms and addressing of fears and safety issues—but for a self-actualization that can be achieved in the last parts of the journey. 

Here’s a glimpse of what it looks like…

Maslow's Hierarchy of Needs 

 

 

 

What’s more? Successive research, in four New York State hospitals, proves that palliative care teams utilizing the aforementioned principles reduce inpatient hospital costs by an average of $6,900 dollars per admission for the average patient. The meta-analysis looked at over four hundred patients with cancer, HIV/AIDS and other severe illnesses. How you ask-

“[Palliative care teams] listen to what patients want to achieve from the health-care system, listen to their goals and what they want to accomplish, then match their treatment to those goals… Some patients might want to pursue all treatment options, while others want to be comfortable and to minimize symptoms…In the setting of this very complex, very sick population, you’re eliminating misutilization, study co-author Sean Morrison states.

More good news:

Financial experts suggest this type of care could save taxpayers—you and me—anywhere from 84 to 252 million dollars in big metropolis’ like New York.

Here is a no-brainer. Patients receive better care---founded on humanistic principles—for less money, with less pain and greater gain. What’s needed? Every hospital, with more than one-hundred and fifty beds needs a palliative care team well versed in Maslow’s approaches. Based on the research, your family and mine will receive better care, for less money, and get more satisfaction. 

-- Liz Schreiber

Posted at 06:25 AM in

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