It’s August and with various staff out on vacations, we decided to collaborate on some posts that review key topics on Health AGEnda. End of life care is one such recurring theme. Why do we write about it so often? Because with most health care expenditures coming within the last few weeks of life, coupled with a widespread dissatisfaction among patients with spending their final days in the hospital undergoing often-futile treatments, the way we approach this care is ripe with opportunities for reform.

What can we do to improve end of life care for patients and families? Read on for our collective thinking on this issue.

First of all, we need to improve communication. There are a number of ways to do this:

And, of course, there are ways NOT to do this. One of the most glaring and maddening was the decision in January 2011 to remove reimbursement for end of life conversations from Medicare in the face of continuing mythology about “death panels”: “A Disappointing About-Face."

Talking about end of life, however, isn’t going to entirely improve how patients experience it. We also need to provide better care. Thankfully, we have a number of tools at our disposal:

POLST, a way for patients to spell out the type of care they want in case of life-threatening illness:

Palliative care

Hospice

Despite hospice’s ability to lower overall medical costs and improve patient and family end of life experiences, it is now under attack because of the way a few for-profit hospices seem to be cherry-picking patients to game the system. Our colleagues over at the excellent blog Geripal commented on this as well.

All of us will be facing the end of life sooner or later—hopefully later, but you never know. With the average age of our population increasing every day, we need to act now to improve care for older adults and all Americans nearing the ends of their lives. Thankfully, we are not the only ones concerned about these issues. Check out these additional resources: