NOT ALL HOSPICE IS CREATED EQUAL

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What is Hospice?  First, it is a type of care and philosophy that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, as well as attending to their emotional and spiritual needs.   OK – so what is palliation?  Palliation is a service that makes you feel better even though it can’t cure you.

Hospice is a positive addition to our medicare system because the focus is the patient.  The goal is to keep each patient as comfortable as possible.  This means additional care over what your loved one is already receiving. Between nurses, social workers and priests, there is someone there two to three times a week to make certain there is no pain or discomfort.

The other side of this service is that it is run by medicare.  That means that Hospice is free if you’re in Medicare as most of our seniors are.   This also means not all Hospice providers are the same.  There are thousands of Hospice providers and you have to be certain that they are doing their job (much like those Medicare doctors I’ve described in earlier articles).

I’ve had two different patients in different facilities with different providers and the difference was night and day.  One provider is in a nursing home that accepts medicaid patients, we’ll call it A for purposes of this article. The other provider was for a client who lived in an assisted living facility – one that cost $4500/month.  This Provider is called F.

A little background – once a patient has been admitted to Hospice, its doctors, nurses and aides “rule” the care.  If the patient is a diabetic he or she will still stay on diabetes medicine but perhaps be taken off non-essential medication depending on the comfort level. Yes, the facility still feeds and provides a clean environment  but Hospice is in charge of the patients comfort.

In most nursing homes the patients are in full blown dementia but not necessarily at the end of their life physically.  Therefore, it is much more difficult to qualify for Hospice in a nursing home.  However, once the patient is accepted the care for my nursing home client was beyond great.  Her nurse was Mark and I could call anytime to check on her (once the children had given their permission)

The other client was in an Assisted Living Facility and qualified for Hospice before the children asked.  They had no indication he was in his last days, weeks or months.  Once their loved one  become uncomfortable and disoriented they started receiving a “run around.”  Parent Your Parents was asked to intervene.  Here’s what we found, the Assisted Living Center blamed it on Hospice and Hospice blamed it on the Assisted Living Center.  We started calling the Hospice office daily to ask for more help. Hospice told the children that babysitters were needed (at $20/hour).  That is when we went into advocate mode.  I reminded the Hospice company that their job was comfort and they had to start providing real comfort, not advice to the children and Assisted Living Center’s employees!  Remember these companies make money and paying people to babysit takes away from their bottom line.  The end result, this Hospice company did what they advertised and found a bed in an extremely lovely location where the client passed away comfortably and peacefully.

Bottom line – not all Hospice is created equal.

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Frances Reaves, Elder Law Attorney and Senior Advocate