Researchers look for ways to improve end-of-life care

How do you want to die?

In medicine, that question is garnering more attention as physicians, nurses, and public health experts take a hard look at end-of-life care and how it can be improved. In a special issue of Johns Hopkins Public Health magazine that looks at death from a variety of perspectives, Jim Duffy's article "A Better Way to Die" examines palliative care—specialized care focused on relieving the pain and other symptoms associated with serious illness—and the expanding healthcare options for those who are terminally ill or near death.

"Ours is the first generation in history that has a say in how we die, and everybody needs to prepare," says Dan Morhaim, an adjunct faculty member at the School of Public Health and Maryland state legislator. "When the end comes, do we want to be getting pummeled in the intensive care unit long past any hope it'll do much good? Or is it more appropriate to be at home?"

Sydney Dy, an associate professor at the School of Public Health, is working to try to answer that question. She is part of a team studying the best ways to deliver palliative care to advanced lung cancer patients starting at diagnosis. They hope to build on a 2010 study at Massachusetts General Hospital that found that patients receiving early palliative care had less depression, less pain, fewer complications, and lived three months longer than a control group that received more traditional hospice care in their final days.

"A lot of us in the field see research as a real need, especially focusing on what strategies work and which ones don't," Dy says. "Part of what makes this field so exciting is that we have such great strides to make. There is so much out there just waiting to be accomplished."