Corina Tracy began her career as a hospice nurse and has served patients at the end of life for more than 25 years. Today, from her vantage point as executive vice president and chief operating officer of Compassus, she says a cultural shift is required to make end-of-life care more mainstream.
Research data repeatedly confirms patients are receiving hospice care too late. One study by Yale University physicians found half of patients admitted into hospice care were admitted only within the last two weeks of their life although they had experienced symptoms related to their conditions for weeks or months prior.
“For physicians and other providers, the conversation around hospice is a high-risk conversation… you’re not sure how the patient’s going to respond,” Corina says. “There’s a lot of data that says if certain things happen, it means you have a limited prognosis, but we don’t let the data, the evidence, trigger the conversations.
“It’s a dilemma. Never do we want to remove autonomy from a clinician; I would never suggest data replace clinical judgment, but I think we can put more data in the clinician’s hands so they feel more confident about their decision… it would be a trigger and a reminder that those conversations need to happen.
“Many years ago I met a wonderful palliative care physician, and she used the term ‘medically possible.’ I think it’s a great and honest way to approach patients about what’s going on with them and helps hope remain, because this is what’s medically possible.
It doesn’t mean there aren’t miracles or things that happen outside of medicine. There may be nothing else medically possible we can do, but there are many other things we can do from an emotional and spiritual support side.”