Final days: Americans getting treated to death

Hope springs eternal. But that American tendency to fight death to the bitter end might not be the best way to depart this mortal coil.

Doctors can't tell you how long a patient will live, but they usually know when an illness is incurable, according to the Associated Press.

Yet doctors persist in practicing "exhaustion medicine"--treating until there are no more options left to try--Dr. Martha Twaddle, chief medical officer of Midwest Palliative & Hospice Care Center in suburban Chicago, told the AP.

More than 80 percent of patients with progressive chronic illnesses such as cancer, heart failure or Alzheimer's disease, say they want to avoid hospitalization and intensive care when they are dying, according to the Dartmouth Atlas Project, which monitors healthcare trends.

Yet hospitalizations during the last six months of life have risen for Medicare recipients between 1996 and 2005. Nearly one in three Medicare dollars goes toward treating chronic illness in the last two years of life.

Meanwhile, the average amount of time spend in hospice and palliative care, which stresses comfort and quality of life after an illness becomes incurable, is dropping because people start too late. In 2008, one-third of people had it for a week or less, according to the National Hospice and Palliative Care Organization.

"People are actually now sicker as they die," Dr. Ira Byock, director of palliative care at Dartmouth-Hitchcock Medical Center told the AP. Often families push for treatment, choosing needless medicine that prolongs suffering over comfort care. But "there are worse things than having someone you love die," he said.

To learn more:
- read this Associated Press article
- here's the Dartmouth Atlas Project's website