Alzheimer's and hospice care: RWJ

University of Chicago Medical Center receives $450,000 grant for innovative end-of-life care program

October 29, 1998

The University of Chicago Medical Center was awarded a three-year grant of $450,000 for an innovative end-of-life care program. The project, called PEACE for Palliative Excellence in Alzheimer's Care, will offer--in conjunction with Hospice of Michigan--full-service hospice care earlier in the progression of Alzheimer's Disease. Typically, hospice care is available only when patients reach the final days of their lives. The University was one of 22 grantees selected from a national pool of 678 applicants by the Robert Wood Johnson Foundation.

Through its new grant program, Promoting Excellence in End-of-Life Care, the Foundation will award $8.7 million to fund programs that broaden access to comprehensive palliative care across a full range of clinical settings for terminally ill patients. Palliative care is an approach emphasizing physical comfort as well as emotional, social, and spiritual well-being.

Promoting Excellence aims to foster long-term changes in healthcare institutions that will improve care for dying patients and their families. The program is a response to research showing that too many Americans die alone and in pain while receiving aggressive medical treatment not justified by its likely benefit.

Under the direction of Greg Sachs, MD, associate professor of medicine at the University of Chicago, PEACE, and the Windermere Senior Health Center, will address patient and family goals and preferences for end-of-life care--including advance care planning, appropriate treatment for Alzheimer's disease and its complications (such as pneumonia or feeding problems), and treatments to improve patients' comfort and dignity. Sachs is a nationally recognized researcher in geriatrics and dementia care.

An affiliated research team, headed by Kathleen Murphy, MD, of Hospice of Michigan, will study the feasibility and impact of extending hospice care to dementia patients earlier than usual in the course of their illness.

Ira Byock, MD, a pre-eminent hospice physician at the University of Montana and the former president of he American Academy of Hospice and Palliative Medicine, is the director of the grant program. "In today's world," Byock said, "people often know as long as several years in advance what chronic disease will cause their death, and this makes it even more urgent for palliative care to be widely available to help people cope with the demands of such diseases."

"These new projects across the country have fresh ideas on how to effect the fundamental changes we need in the structure, organization, and priorities of the healthcare system in order to promote high-quality end-of-life care. Their work, we hope, will help make changes that are long-lasting and spread to other institutions. In the long run, we hope they improve the quality of life for a great many dying patients and their families," Byock said.

The Robert Wood Johnson Foundation, based in Princeton, New Jersey, is the nation's largest philanthropy devoted exclusively to health and healthcare. It became a national institution in 1972 with receipt of a bequest from the industrialist whose name it bears and has since made more than $2 billion in grants. The Foundation concentrates its grant-making in three areas: to assure that all Americans have access to basic healthcare at a reasonable cost; to improve the way services are organized and provided to people with chronic health conditions; and to reduce the personal, social economic harm caused by substance abuse--tobacco, alcohol, and illicit drugs.