Expert Says Cultural Movement Needed to Transform End of Life Experience in America
By Larry Beresford
Transforming the way our society approaches end of life will take a cultural movement comparable to the natural childbirth movement that reshaped the way we view the birth experience, says Peggy Maguire, president of Cambia Health Foundation.
“We know that how we live well at the end of life can’t be left to the medical professional to decide,” Maguire said in a talk at the recent End Well Symposium in San Francisco. “(The natural childbirth movement) was consumers putting pressure on the system, saying: ‘We want a more human experience.’”
Cambia Health Foundation has invested $30 million in advancing access to palliative care and was the largest philanthropic supporter of End Well, a full day of Ted Talk-type presentations on Dec. 6 that focused on transforming end of life into a human-centered experience.
“We’ve invested in palliative care so heavily because we think it helps people live each moment. We saw an opportunity to make it personal,” Maguire told the End Well crowd. “All of us will be patients or caregivers; create the health care experience you’d want for yourself.”
Foundation Leads by Doing
The Cambia Health Foundation is one arm of Cambia Health Solutions, which also has with regional health plans in four Western states, a new consumer experience platform that is trying to personalize health care delivery, and an entrepreneurial investment company called Echo Health Ventures.
In addition to supporting End Well, the foundation has invested in palliative care program development at eight hospitals, the creation of an integrated comprehensive palliative care benefit for its insurance plans, and the Sojourn Scholars Program, with 12 emerging palliative care academic leaders per year selected for two years of support and mentorship.
“We started paying for advance care planning conversations with physicians before Medicare did,” she said. “Our role is being a catalyst for change and a connecter. We want to find new solutions.”
Learning from the Past
Maguire acknowledged that creating a cultural movement to transform end of life has been attempted before. She said a similar movement around hospice that began in the 1970s fell short in part because advocates emphasized the Medicare hospice benefit and its requirement that patients have six months or less to live.
“The way we avoid the errors of the past is to make this all about the human experience—not the medical experience,” she said. “The value of palliative care is that it happens alongside of curative care. It helps you live your best life every day.”
The field of palliative care is also challenged to identify—and then consistently use—a common language that can resonate with consumers, Maguire said. She said Cambia plans to bring palliative care leaders together for a conference that will identify this common language for professionals to use.