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Explore our coverage of government and politics.

End Of Life Care Changing In Vermont And Nationally

A new Dartmouth Atlas study shows a major shift in “end of life” services for Medicare patients.

The study is based on a review of the health records of more than a million Medicare patients who died during 2010.

Dr. David Goodman, the lead author of the study says the report shows a much greater use of home and hospice care for terminally ill patients and less hospital care.

He thinks this is happening because more people are using Advanced Directives to spell out the kinds of treatment and medical services they want in the final months of their life.

Goodman says it’s critical for the family members of the patient and the patient’s doctors to have and respect this information.

It is a situation where physicians are finally catching up with patients in their own wishes - Dr. David Goodman

"There has been progress and this report reveals some of the progress that’s been made, it’s very encouraging,” said Goodman. “It’s a situation where physicians are finally catching up with patients in their own wishes there’s also a lot more work that needs to be done. We’re not there yet but it’s nice to that progress is being made.”

And Goodman says it’s taken awhile for the medical community to embrace the wishes of patients in the final months of their life.

“While it is anticipated again in theory, the health care system is all powered up and geared up for life saving treatments generally,” said Goodman.  “And ignores I think these other realities and these other preferences by patients.”

Goodman says the use of home care and hospice programs varies greatly across the country and he says research shows that Vermont has one of the highest rates of using these services.

Bob Kinzel has been covering the Vermont Statehouse since 1981 — longer than any continuously serving member of the Legislature. With his wealth of institutional knowledge, he answers your questions on our series, "Ask Bob."
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