New Hampshire Brain Injury Association pushes for improved palliative care access

A pivotal discussion on improving end-of-life care took center stage during the New Hampshire House Health, Human Services and Elderly Affairs meeting on April 23, 2025. Lawmakers and health professionals emphasized the urgent need to enhance access to hospice and palliative care services, highlighting a significant gap in current healthcare provisions.

Dr. Chang, a member of the integrative pain care committee, passionately advocated for better hospice and palliative care, referencing the insights of Tim Quill, a renowned expert in the field. Quill argues that if hospice and palliative care were more effectively provided, the need for right-to-die legislation would diminish. "We need to do a lot better," Dr. Chang stated, stressing that many patients currently lack adequate access to these essential services.

The meeting also addressed the stark differences between hospice and palliative care, particularly in how they are funded. While hospice care often includes a comprehensive range of services under a bundled payment model, palliative care is typically constrained by a fee-for-service system, limiting patient access to necessary treatments. Dr. Chang noted, "Access to a lot of these services is limited, and that's the big problem."

Representative McKay raised concerns about the emotional challenges surrounding end-of-life discussions, acknowledging that many people struggle to confront these topics. Dr. Chang recommended reading works by Elizabeth Kubler Ross, a pioneer in the field, to better understand how to support individuals facing death.

Theresa Rosenberger from the New Hampshire Brain Injury Association echoed the call for improved palliative care, particularly for individuals with disabilities. She highlighted the need for education on the differences between hospice and palliative care, noting that many caregivers are unaware of the available options when their loved ones are in need.

As the meeting concluded, the committee recognized the importance of addressing these issues comprehensively, with a focus on ensuring that all age groups and communities, especially those with disabilities, receive the necessary support and care. The discussions set the stage for potential legislative action aimed at reforming and enhancing end-of-life care in New Hampshire.