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Local End of Life Care Gets Mixed Review

By Eileen Buckley

Buffalo, NY – New York State received mix grades in a national report on caring for the dying.

Last Acts, the nation's largest coalition working to improve end of life care, issued the state-by-state report cards Monday.

The state received five "D's" and just two "B's". Low grades were issued for the "location of death".

Doctor Robert Milch, medical director of Hospice Buffalo, said 70 to 80-percent of terminally ill people claim they would rather die at home.

But, only 21-percent statewide had their wish.

The report also gave low grades for the lack of hospitals offering hospice programs.

Dr. Milch said hospice is under utilized, with the length of stay averaging only 19 days statewide.

He said in Buffalo it was even shorter - just 14-days.

"We know to be reasonably affective in supporting patients and families that we need two to three months of involvement with them," said Milch. "So there is very late referral of utilization for Hospice services."

Higher grades were given for the number of state hospitals reporting pain management programs, but policy barriers stand in the way of good pain management.

Dr. Milch said the report card also raises the problem of communication between doctors and patients.

"In medicine we have a death defying profession and it's a death denying society," said Milch.

"That's a tough hurdle to clear in raising these issues around when is it time to reasonably be considering Hospice services."

Dr. Milch said health care professionals and the public need to be educated on decision making for the terminally ill.

The report said America does a "mediocre" job when it comes to caring for dying patients.

Leaders of Last Acts said Medicare is to blame, and are calling for reform.