The Journal of Palliative Medicine reported in 2010 that only around 20 percent of terminally ill elderly patients had their end-of-life wishes documented in their medical records. Much of the painful end-of-life decision-making is then shifted onto family members, who are frequently left feeling isolated and pressured into pursuing invasive treatments. As a result, despite the majority of Americans voicing the desire to die in comfort at home, CAPC statistics show that around 80 percent of deaths still occur in hospitals and intensive care units.

Many doctors fail to call in the palliative care team when patients are terminally ill, fearing that it looks as though they should expect the worst. Yet the resounding response from patients and families who have experienced the interdisciplinary benefits of palliative care, within a hospital or at home via hospice, was that they wished they had known about it sooner.

Terminally ill patients who received early palliative care experienced less depression, had a better quality of life, and survived longer than those who were given “life prolonging” treatments or even just standard care.

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Over the past six years palliative care has been one of health care’s fastest growing practices, becoming ever more widely accepted by patients, by doctors, and by hospitals. The number of teams has doubled, new fellowships have been added and the Center to Advance Palliative Care (CAPC) reports that 63 percent of hospitals with over fifty beds now have a palliative care team. Research has also shown that hospitals could save $6 billion a year in costs by fully integrating palliative care programs across the U.S.

But its use is not universally popular — there are those who believe that making palliative care a specialty adds confusion to an already baffling health care system. A study conducted this year in The New England Journal of Medicineby Dr. Timothy Quill and Dr. Amy Abernathy voiced concerns that the growing acceptance of palliative care as a specialist field could actually encourage patient care to become further fragmented. The authors suggested that primary care clinicians and specialists may begin to assume that basic psychological and social support for patients with life threatening illnesses is not their responsibility — a huge problem given that the current number of interdisciplinary palliative care teams won’t be able to fully supply demand for years to come.

Educating doctors and specialists about the role of palliative care has also been an ongoing battle in America’s hospitals. “One of the most common misconceptions about palliative care and hospice is that they speed up the dying process, but that’s just not true,” said Dr. Craig Blinderman, a palliative care specialist. “It’s about managing symptoms and tailoring a patient’s care to their values and goals, whatever those are.” Indeed, according to a 2010 study published in The New England Journal of Medicine, terminally ill patients who received early palliative care experienced less depression, had a better quality of life, and survived longer than those who were given “life prolonging” treatments or even just standard care.

“One of the biggest obstacles that we have is in the current lexicon of medicine,” said Fran Heller, a senior palliative care social worker, who works closely with patients’ families during times of crisis. She argues that physicians, nurses, and social workers need to readdress how they speak about the dying process. “Too often the doctors refer to it as withdrawal of care” she said, shaking her head. “We never withdraw care — we withdraw treatments.”