For One Community, a Simple Hearse Has Profound Effect

Uganda has the best quality of death among low-income countries, according to the Economic Intelligence Unit. Its success stems in part from the strictly regulated but available supply of morphine, which is distributed by pharmacists in labeled bottles.

The palliative care system in Kerala, India, has been singled out as a beacon of hope in offering the possibility of a dignified death to everyone by safely providing morphine.

Despite years of change, African Americans feel ostracized from the medical care community that is dominated mainly by white people, especially when it comes to hospices. Some are trying to remove the stigma of hospice care as well as make health care systems more fair.

A hospice patient's end-of-life desires are most often thwarted when well-meaning loved ones see the patient in some sort of distress. New programs ask first-responder paramedics to work with hospice programs to better honor a person’s end-of-life wishes.

These days, most rural communities in the U.S. are elderly communities - 15 percent of Wyoming’s population is over 65 and a high percentage of them live on ranches in small towns. New caregiver programs allow seniors to continue living at home and to keep doing what they are able, with assistance provided if needed.

Patients' last years of life are the most expensive for the health care system. For a fifth of the cost, a Zen hospice program, in San Francisco, is helping those who are dying improve their quality of death by enjoying the present.

People who are homeless and have a terminal illness usually end up in the emergency room which is more expensive and less effective. The UW Medicine’s Harboview Medical Center is the first U.S. program that sends mobile teams to provide palliative care, comfort care, to homeless people facing terminal illness.

End of life planning is a thorny issue, but a pre-hospice program in San Diego is working to address the tough conversations and place seniors in care for their final years. They found that by bringing care to patients in their homes, they save patients’ emergency hospital visits and save the system money. Medicare and insurance don't usually pay for in-home palliative care, but companies that work with the Affordable Care Act are using creative financing to offer quality care without added expense.

Mongolia, under the influence of Dr. Odontuya Davaasuren, has become very advanced in its palliative care. Patients are given full information about their diagnosis, are provided with the proper pain medications, families are involved and guided and spiritual considerations are included creating a better system of care.

Pennsylvania has a compassionate release law for inmates who are terminally ill so they don't die in prison, but in practice it has become even more difficult for inmates and their families to take advantage of it. The number of elderly prisoners in the state has soared. Advocates recommend prisoners get an automatic compassionate release when they receive a terminal diagnosis so the family is not burdened with trying to figure out the complex process and paperwork.