Studies have shown that more people are dying at home, but that may be misleading because many patients still are admitted to ICUs and have repeat hospitalizations at the end of life, according to health care chaplaincy consultant George Handzo. Palliative care and hospice teams frequently say that referrals come too late, according to Handzo. "My fear is that for some patients the medical team is holding off having real goals of care discussions until death is imminent," he writes.

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