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REPORT: IOM Emphasizes Need for Person-Centered End-of-Life Care

November 20, 2014

An individual’s preferences should be honored right up to the end of his or her life, a new book-length report by the Institute of Medicine (IOM) argues.

Dying in America, prepared by the IOM’s Committee on Approaching Death, maintains that “a patient-centered, family-oriented approach to care near the end of life should be a high national priority.”

The report lists a dozen components that contribute to quality end-of-life care, including “management of emotional distress; referral to expert-level hospice or palliative care if needed and desired; and regular revision of a care plan and access to services based on the changing needs of the patient and family.”

However, the 500-page report acknowledges that there are barriers to achieving these goals, particularly in a way that is affordable for the majority of Americans.

The report acknowledges the role that direct-care workers can play in facilitating humane, patient-centered end-of-life care. Direct-care workers are uniquely positioned to provide this care from their position “at the bedside” of consumers, the report says.

A section on direct-care workers recommends raising federal minimum training standards for direct-care workers to 120 hours. It also cites a separate IOM report recommending that state Medicaid programs improve reimbursement rates to providers in order to improve workers’ wages and benefits.

“I encourage all providers and practitioners in the field of aging to review this impressive resource,” said PHI Organizational Consultant Anna Ortigara.

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