When the life of a loved one is coming to an end, it is reported that there isn’t a single specific point at which end-of-life care begins; it very much depends on the individual. End-of-life discussions are fundamental in ensuring the needs of both the ill and the loved one are met.
Now, Medicare is making advances to have these crucial discussions that will start paying for physicians to have these advanced-care planning conversations with patients. It's a new policy that could be released in the foreseeable future.
This has been a critical issue ever since the Obama administration tried to implement a policy that paid doctors to have private insurers to cover advanced-care conversations in 2010. It didn't pass. At the same time:
many states have passed laws making it easier to document end-of-life care goals in medical records, and in Congress, bipartisan bills in both the House and the Senate have called for physician reimbursement for such conversations. No bills have made it to floor votes, however.
Patient needs are still at the forefront of these discussions, especially since it's been reported that:
"Many patients in the ICU can't make decisions about their own care, surrogates often speak on their behalf and collaborate with the treating physician to determine treatment goals. But in many cases, they have no idea what the patient would want. Recent research shows that fewer than half of terminally ill patients have advance directives. And one study showed that discussions about end-of-life care are most often hampered by patients and their family members who don't want to talk about such plans."
"many surrogates have no experience in making end-of-life decisions for someone else and struggle in that role, says Hutchison. Depressed and anxious over their loved one's illness, making decisions without a recommendation from the treating physician may be overwhelming, Hutchison argues. A physician's input can help family members, who have no medical background or training, to make decisions, but doctors should be open to other perspectives."