Dr. Michelle Reisner, medical director of the Palliative Care program at Jersey City Medical Center, isn’t out to kill you — but she does want to help you die with dignity and grace.
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According to the Dartmouth Atlas of Health Care, an exhaustive study that found that chronically ill patients in New Jersey spend an average of nearly $40,000 during the last two years of life, the highest in the nation ($10,000 more than the national average and over $15,000 more than Idaho, the state that spends the least). In addition, these same New Jersey patients pay 25 visits to specialists in the last six months of life, also the highest in the nation, and about double the national average.
“Elderly patients often spend their last days going from one test to another, with the cardiologist looking at the heart, the GI specialist worried about their digestion, the endocrinologist checking on their diabetes and the neurologist concerned about their brain,” said Dr. Reisner. “In many cases, no one is there to look at the big picture. That’s what we try to do.”
Doctors in New Jersey also admit an above average number of patients to hospitals and tend to prescribe significantly more care. Patients here tend to stay longer in the hospital than those in other states – an average hospital stay of 6.2 days for Medicare patients compared to the national average of 5.5, according to the New Jersey Hospital Association. A 2006 study underwritten by Horizon Blue Cross Blue Shield of New Jersey and the Robert Wood Johnson Foundation called New Jersey among the most “resource intensive” in the nation. But the study found no corresponding improvement in the quality of care.
So if you live in New Jersey, you will get more aggressive care at the end of your life — but that doesn’t necessarily mean you will have a better quality of life or live longer.
That’s why palliative care is so important: It helps those with chronic illnesses make good decisions about the conclusion of their lives.
You can juice up a person with pain medication, but that doesn’t do anything to treat the underlying cancer that is unchecked and eating up the patient from the inside out.
While it may be hard to confess in our “life at any cost” notion in America, sometimes the best remedy for the inevitability of death is to accept the notion that no life lasts forever and that sometimes having a calm and clean end is better than going out desperate and depressed.