Op-Ed: Improving End-of-Life Care Should Be a Priority for New Jersey

Michael Maron | December 12, 2018 | Opinion
Helping patients who are coming toward the end of their lives is one of the state’s most important healthcare issue

Michael Maron
After 18 months, the New Jersey Governor’s Advisory Council on End-of-Life Care recently released its much-anticipated report, with 26 policy recommendations for the Department of Health. With November being National Hospice and Palliative Care Month, their recommendations are both timely and important to improving the quality of end-of-life care and reducing healthcare costs.

As NJ Spotlight reports, the council warns the department that “there is no clear vision of how the healthcare system will be able to meet the obvious growing needs for chronic, palliative, and end-of-life care. This increasing demand, as well as the need for improvements in accessing palliative and end-of-life care, are key challenges.”

Indeed, one of the most important healthcare issues our state must tackle is improving care for New Jersey patients in the final chapters of their lives. We know that while life-extending care and other medical treatments may lengthen life, they often do so at the expense of quality of life. Our goal is to help patients and families understand the difference and maximize the moments they share in their final months, weeks, days or hours together.

According to the Dartmouth Atlas of Health Care, New Jersey has consistently ranked one of the highest states (49th out of 50) in the nation for Medicare costs in the last six months of life, with no indication of decline. It also revealed New Jersey residents spend 44 percent more days in the intensive care unit compared to the average American and 30 percent more days in the hospital in the last six months of life.

Stressing the system ‘to near collapse’

Two particular weak points in the healthcare structure are stressing the system to near collapse. The first is inadequate symptom management, leading to re-hospitalization and poor outcomes. The second is a lack of expertise in conducting sensitive conversations regarding goals of care based on accurate prognoses. The conversation about end-of-life care is an important one that all families need to have and that our policymakers need to address. We can — and must — include advance directives as a critical component of a patient’s electronic health record (EHR).

For the past several years, all branches of state government collaborated in support of Holy Name’s residential hospice, the Villa Marie Claire, and our mission to improve New Jersey’s performance when it comes to end-of-life care. Villa Marie Claire is the only freestanding hospice in the New York/New Jersey metropolitan area and offers a unique approach that encompasses the full spectrum of end-of-life care: the patient, family, caregiver, provider and community.

The state’s annual appropriation for Villa Marie Claire supports the project’s eight key initiatives, which aim to address every aspect of care in the two years leading up to a person’s death and the 12 months following — the development of education, training, and state certification courses for doctors, nurses, social workers, and other healthcare professionals; research and comparing end-of-life-experience and quality of life for those enrolled and not enrolled in hospice programs; and policy recommendations in partnership with the Medical Society of New Jersey.

While our main goal is improving the quality of care for all New Jerseyans, creating a standard for the appropriate use of end-of-life-care resources will result in a reduction in state and federal costs stemming from unnecessary hospital admissions, ER visits, procedures, tests, and treatment.

We are proud to lead a statewide effort to improve end-of-life care in New Jersey, and we thank the governor and legislative leaders for their support of this important healthcare issue.