Better palliative care for high-risk seniors in home settings can reduce emergency room visits and save on health care spending, says a new study citing the current health care delivery system’s failure to implement the care model despite growing evidence of its efficacy.
There are gaps in understanding what works well and actually delivering those services in optimal settings, say researchers from the Indiana University School of Medicine in a study published in the October 2013 issue of the Journal of Palliative Medicine.
“The fields of palliative care and geriatrics have developed a growing body of evidence in support of customized care models aimed at meeting the needs of frail, vulnerable, and seriously ill patient populations,” the study authors write. “The problem is not that we don’t know what to do—the problem is that we don’t do what we know.”
Many seniors need long-term care services and supports, which can be provided anywhere form the nursing home to a patient’s home, and the need for formal long-term care is expected to triple by 2050, according to projections.
Seniors with a combination of chronic or serious illnesses, functional limitations, and cognitive impairments represent a “high cost, high need” group who aren’t well-served under the current health care system, the study says, and palliative care principles—including early advance care planning, communication about prognosis, and practical support for families, along with presenting a variety of treatment options—are intended to relieve distress and improve quality of life.
“Despite evidence of multiple approaches that do ‘work’ for this population, there has been a failure to translate the successes of research and clinical demonstration projects into widespread practice,” the researchers say.
The study concludes by recommending several research priorities aimed at supporting “rational policy development” that will address the needs of senior palliative care patients, including studies creating a roadmap for scaling and implementing successful care models and researching creative financing models for health care delivery.
Written by Alyssa Gerace