Health Care System Makes it Difficult for End-of-Life Patients


By Joseph Franz

No matter our political, religious, cultural or socio-economical differences, the one thing that we all have in common is death. Unfortunately, creating a “good death” to the elderly and sick is not easy and it could be getting even more difficult.

A recent

New York Times article

highlighted the struggles of a 91-year-old Joseph Andrey whose dying wish was to be able to return to his apartment so that he might pass away in the comfort of his own home. Unfortunately, instead he felt like a prisoner of the health care system, a system that had pushed him back and forth between hospitals and rehabilitation facilities so many times that he and his daughter had lost count. Sadly, Joseph is not alone in this story.

A new report from The Institute of Medicine defines the elements of a good death as one that is “managed carefully over weeks, months or even years, through many ups and downs. Ideally, health care harmonizes with social, psychological, and spiritual support as the end of life approaches. To this end, care near the end of life should be person-centered, family-oriented, and evidence-based.”

In our current system, however, palliative care – or care meant to relieve pain when there is no cure – often fails to meet the needs of patients. Policies and payments that support high-quality end-of-life-care are largely inadequate or absent altogether. Oftentimes, regulations that were put in place to protect the patient are circumvented or ignored.

One of the main problems is that profits and bottom lines benefit from intensive and expensive treatments far more than respecting the wishes of people at the end of their life. Some studies have even shown that the expensive treatment that is frequently ordered is either unnecessary or harmful to the patient.

Joan M. Teno of Brown University’s heath system says, “Until our current health care system is no longer based on piecework reimbursement, and becomes accountable for person-centered care, we all need vigilant advocates to protect us from this ‘medical-industrial complex.’”

At the Encinitas Nursing and Rehabilitation Center, we firmly believe in person-centered care and we always put the patient’s needs at the forefront of every decision. If you would like more information about skilled nursing and rehabilitation, please don’t hesitate to contact us at

or call us at (760) 753-6423.