article study Flashcards
what did William Osler find?
that only about 1 in 5 of the deceased seemed to be suffering in their final days
the % of deaths occurring in hospitals, nursing homes has risen steadily since the 1930s to nearly ___% today
80%
most people in the industrial world still die on ______ or ______
hospitals or nursing homes
what did the study contradict?
the widespread belief that tyrannical physicians are keeping many patients alive against their will
what is the 2nd most common cause of death in US according to the study (after cancer)?
congestive heart failure
people who had congestive heart failure, ___% who were expected to live less than __ months survived for at least another ______?
28%, 6 months, year
what does Lynn think about assisted suicide?
inappropriate to legalize assisted suicide when so little has been spent to explore alternatives
what does the hospice concept involve?
provides comfort, medical, psychological, social and spiritual services for those who are beyond cure and approaching death
when did the federal medicare program began covering hospice care for people expected by physicians to live less than 6 months?
1983
medicare officials can deny payment or require co-payment for which patients?
patients whose prognoses are deemed to have been positive
most hospice patients are dying of?
cancer but a lot are afflicted with aids
who is John j. Mahoney?
president of national hospice organization
medicare spent almost __% less on hospice patients during their last month of life that on those on receiving standard care?
50%
medicare currently spends well over ___$ annually on hospice reimbursements and average daily cost for individual patients is about $____ (same as nursing home care)
$1 billion, $100
one possible solution to combating pain problem?
program called medicaring
what is medicaring
extend hospice like services to patients who have incurable diseases but don’t qualify for hospice care bc they have unpredictable conditions/expected to live longer than medicare guidelines allow
preventing a problem is preferable to _____________?
reacting to it
chronic pain can …..
alter the central nervous system, making the discomfort more sever and intractable through a “kindling” effect
seriously ill van be….
trapped in a vicious cycle of intensifying distress
what is common among the dying
shortness of breath
what can shortness of breath trigger
panic that exacerbates the breathing problem
what are major obstacles to proper treatment of pain
laws and social attitudes that hinder prescriptions of analgesics and opiods (like morphine)
medical technologies save lives but…
can also prolong suffering of terminally ill
common afflictions of severely ill?
pain, bedsores, incontinence, depression and psychosis
