Quality end of life care: the case for a MediCaring demonstration.

People in the last phase of life often need a very different care system than the one currently available. MediCaring extends the hospice model to a larger population with a wider array of services over a longer period of time with an emphasis on symptom management, maintenance of function, comfort and family counseling. This model requires simultaneous efforts to secure longer life and to make the patient and family ready for dying. Services range from psychological and spiritual counseling for the patient and family, to emergency care access, to inpatient respite care. MediCaring would accomplish these goals without increasing costs, primarily by diminishing the use of acute care interventions that may no longer serve the patient.