End of Life Care
End of life care refers to that part of the medical profession directly involves in the treatment of individuals with fatal illnesses. Medical professionals face a host of questions when it comes to end of life care, including a patient's right to self-determination regarding the level of intervention, ethics, and even the rationing of resources.
Medicare and End of Life Care
In the United States, it has been estimated that as much as 27 percent of Medicare's annual budget is allocated towards patients in their final year of life. It is this period when individuals require the most hospitalization, medical treatment, and intervention. Issues of patient autonomy have arisen as a result, when patients and their families must determine if aggressive treatment is ultimately worth both financial and emotional cost.
Medically, end of life care is frequently concerned with the final hours of a person's life. Numerous signs indicate when a person is approaching death, including a decreased need for food and water, social withdrawal, changes in metabolism, and irregular or shallow breathing. Potential problems that may arise include issues of pain management, agitation or delirium in the patient, dyspnea, and secretions in the respiratory tract. Most of these are controlled with medications, including opioids, benzodiazepines, and atropine. Many of these medications are administered at constant low levels through an infusion pump.