More insurers should cover hospice care

Great Eastern Life's Integrated Shield Plan, which covers both home and hospice care, is a move in the right direction ("Insurers customise plans for the elderly"; last Thursday).

There is overwhelming evidence that hospice care benefits patients more than going all out to fight a terminal illness.

Beginning in 2004, Aetna, an American insurance company, offered hospice care to policyholders with a life expectancy of less than a year.

A two-year study found that the percentage of patients using hospice care grew from 26 per cent to 70 per cent.

These patients also visited the Accident and Emergency departments half as often as control patients, and their use of hospitals and intensive-care units dropped by more than two-thirds.

Overall costs fell by almost a quarter.

A landmark 2010 study from the Massachusetts General Hospital showed that cancer patients who received both palliative and the usual oncology care stopped chemotherapy sooner, entered hospice care far earlier, experienced less suffering at the end of their lives and lived 25 per cent longer.

In a study of terminally ill cancer patients, those who had discussions with their doctors about their end-of-life care preferences were far less likely to undergo cardiopulmonary resuscitation, be put on a ventilator or end up in the intensive-care unit.

Most of them enrolled in hospices. They suffered less, were physically more capable, and better able to interact with others for a longer period of time.

Their family members, having been spared the anguish of being witnesses to prolonged suffering, were also markedly less likely to suffer from depression six months after their loved one's death.

I have personally witnessed the benefits of hospice care.

My mother's doctor recommended hospice care when chemotherapy not only proved ineffective but also led to severe side effects that landed her in hospital.

After stopping treatment, and being in the good hands of the hospice nurses and doctor who visited regularly, she had a good quality of life for a year before she died peacefully - and with dignity - at home.

Instead of pursuing treatment at all costs, and in the face of dwindling odds, terminally ill patients would be better served by having an honest discussion with their doctors about the realities of their prognoses.

I have found the book, Being Mortal, by Dr Atul Gawande an illuminating read on hospice care, among other end-of-life issues.

I hope all other insurers will follow Great Eastern Life's lead in covering hospice care.

Maria Loh Mun Foong (Ms)

This article was first published on November 17, 2015.
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