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Brown
expert offers guide to End-of-Life Care
PROVIDENCE, R.I.
[Brown University] — Years ago, dying
patients in most communities often had a
single option if they needed hospice care.
Now they have many more; competition reigns.
This is one crucial reason why a Brown University
researcher and end-of-life expert has helped
develop user-friendly guides for both
doctors and patients about the best hospice
care options in the marketplace.
“While all hospice programs are very good, there are some
programs that are really excellent,” said
Joan Teno, M.D., a professor of community
health and medicine at the Warren Alpert
Medical School of Brown University.
“You want to choose the hospice program that is striving
and achieving excellence in quality of
care.”
Teno’s guide for doctors published in
the Feb. 11 edition of the
Journal of
the American Medical Association,
part of a series titled “Perspectives on
Care at the Close of Life.”
Her article, “Referring a Patient and Family to
High-Quality Palliative Care at the Close of
Life,” is co-written with Stephen Connor,
vice president for research and
international development at the National
Hospice and Palliative Care Organization.
Teno and Connor are at work on a user-friendly guide for
patients and families that incorporates a
portion of the
JAMA
article but with more streamlined language
accessible to the general public.
Teno said she and Connor worked to synthesize existing
literature on end-of-life, or palliative
care with a simple goal.
They wanted to create something easy to understand
for both physicians and families who must
choose between hospice or hospital-based
end-of-life care.
Having such information at hand when a patient or family
member is soon to die is increasingly
important, Teno said, in large part because
of heightened competition in the
marketplace.
“And so we tried to define what you should expect,” she
said, “and define what high-quality care
means at the close of life.”
Overall, Teno said, she and Connor hoped to compile
guidelines that addressed the three C’s —
whether care is “competent, compassionate
and coordinated.”
For families, Teno and Connor are developing even simpler,
easy-to read guidelines they’ve dubbed “The
Five C’s.”
They urge families to make sure a hospice or hospital
palliative care program will provide competent
care by an interdisciplinary team;
care centered
on the patient and family needs;
coordinated
care that provides access to needed
services;
compassionate
care; and
care committed
to quality.
Teno and Connor suggest families should make sure a hospice
program is certified by a recognized
national program, determine if a full-time
medical director is on staff, and whether or
not staff is available 24 hours a day, seven
days a week.
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