January 2003

Scanlon Provides Expert View on End-of-Life Care


Colleen Scanlon, RN, JD, senior vice president of advocacy for Catholic Health Initiatives, participated in a media briefing in November that introduced the report "Means to a Better End: A Report on Dying in America Today." The briefing, which took place in Washington, D.C., was broadcast on C-SPAN. The "Means to a Better End" report was released by Last Acts, a coalition to improve end-of-life care, with support from the Robert Wood Johnson Foundation. The report revealed that only 11 percent of adults think the U.S. health care system is doing an excellent or very good job caring for dying persons, and 26 percent said the health care system is doing a poor job. The report also issued an end-of-life care grade to each state based on evaluation of eight key elements of end-of-life care, with "A" being the highest grade and "E" the lowest. Most states earned "Cs," "Ds" and even "Es" on the majority of the criteria. Other key findings include:
  • Nationally, about 25 percent of deaths occur at home, although more than 70 percent of Americans say that home is where they would prefer to die.
  • About half of all deaths occur in hospitals, but less than 60 percent of hospitals in any given state offer specialized end-of-life services.
  • Nationally, 14 percent of hospitals offer palliative care, 23 percent offer hospice care and 42 percent offer pain management services.
  • The percentage of deaths that include a hospice stay varies by state from about five percent to 42 percent, but most states have only fair use of hospice services.
  • Experts agree that patients need at least 60 days of hospice care to maximize its benefits, but average hospice stays range from 14 to 43 days.
In her comments at the media briefing, Scanlon put a human face on the report by sharing stories of a variety of end-of-life care experiences. "The stories emphasized the need for all nurses, physicians and other clinicians to be taught how to provide quality end-of-life care, including advance care planning, pain and symptom management and attention to the emotional and spiritual needs of patients and families," she said. "There is such a thing as dying well, and it needs to happen all the time. The Last Acts report is another piece of evidence that health care needs to do more to improve end-of-life care." For more information on the "Means to a Better End" report, visit the Last Acts Web site at www.lastacts.org.