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Palliative Care Necessary Before Last Stages of Life: New Study Casts Doubts on Old Perceptions

New Study Casts Doubts on Old Perceptions

New York, NY (May 15, 2003) — New research from the San Francisco VA Medical Center, published in the Journal of the American Geriatric Society (51:492-498), has shown that progressive frailty, rather than sudden, predictable death, may mark the end of life for many older patients. Studying data collected from 917 patients over a two year period, researchers found that there was no clear point in time that signaled death was imminent.

“Death is unpredictable,” says Dr. Diane Meier, director of the Center to Advance Palliative Care, a national program of the Robert Wood Johnson Foundation. “This is why palliative care must be available to people at any stage of a serious illness – with or without curative treatment.”

At present, end-of-life care is modeled on patients with diseases such as terminal cancer, which is often characterized by sudden death. While such care may be appropriate for those who conform to the cancer model of terminal illness, this is not the case for the approximately 75% of Medicare patients who die of disease other than cancer.

“The current American model of end-of-life care is an irrational system that doesn’t work for most patients,” Meier says. “As the new study shows, appropriate care should be driven by what patients and families need, not by what the Medicare structure dictates.”

The study concludes that the frail elderly can deteriorate slowly, and clinicians who care for older people must refer them to care systems that can provide assistance and care for the last years of life, not just months or days.

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The Center to Advance Palliative Care is a national program of the Robert Wood Johnson Foundation, providing hospitals and other healthcare settings with the tools and technical assistance to develop hospital-based palliative care programs. Visit the CAPC website at

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