Studies have shown that the more health care that is available the more people consume. And the more health care consumed, the worse people are. It’s true, places with less access to health care are healthier places.
So a new finding that acute care hospital tend to insert more feeding tubes into nursing home residents with dementia is not surprising. The New York Times reports:
Some hospitals inserted feeding tubes in as few as one of every 100 patients with advanced dementia, others in as many as one of three.
Large hospitals and for-profit hospitals were more likely than others to insert the tubes, as were hospitals deemed aggressive about providing end-of-life care.
The findings suggest that such decisions are more likely to be based on hospital practices than on the wishes of patients and their families, said the lead author, Dr. Joan M. Teno, a professor of community health at the Warren Alpert School of Medicine.
The study confirms the findings I describe in The Art of Dying, that doctors and hospitals are not attuned to the needs of the dying. They tend to treat the illness because that’s what they do, and that’s why people go to see them. But for those near death, such acute care is often an obstacle to dying well. Patients (if of a sound mind) and families must be aware of these tendencies an resist them, instead choosing less aggressive and more caring, comforting medical treatment.