[gdpawel]

A new study published in the Journal of the American Medical Association finds offering end-of-life counseling aids last days. Offering such care to dying cancer patients improves their mood and quality of life. It was funded by the National Cancer Institute.

A House proposal allows Medicare to pay doctors to chat with patients, if they desire it, about living wills, hospice and appointing a trusted person to make decisions when the patient is incapacitated.

In the new study, trained nurses did the end-of-life counseling, mostly by phone, with patients and family caregivers using a model based on national guidelines. All the patients in the study had been diagnosed with terminal cancer.

Half were assigned to receive usual care. The other half received usual care plus counseling about managing symptoms, communicating with health care providers and finding hospice care.

Patients and their caregivers also could attend monthly 90-minute group meetings with a doctor and a nurse to ask questions and discuss problems in what's called a "shared medical appointment." Patients who got the counseling scored higher on quality of life and mood measures than patients who did not.

Accoring to one of the researchers, patients getting such counseling often thank the nurses helping them. They seem to feel a whole lot better knowing there's someone who's looking at the rest of them and not just the tumor.

In both groups, hospital stays were rare: six to seven days on average during the patients' last year of life. It is patients and families in their own living rooms who are dealing with end-of-life care. They're not in the hospital,they're at home.

This is about helping people live with the diagnosis the doctor has given. This study reflects on what kind of support people deserve when they're dying.