Category Archives: hospice forum posts

Hospice Costs: The Rest of the Story

Legendary broadcaster Paul Harvey delivered a popular feature called “The Rest of the Story.” He would hook listeners with a catchy opening, provide some vague details and then reveal an often surprising ending. His concluding line was always: “And now you know… the rest of the story!”

How about this for an attention getting headline? “Government Spending More Than $12 Billion On Hospice Care.”

In 2011, ABC News reported that the amount Medicare pays hospice care organizations had increased 53% from 2005 to 2009. The main reason, says the report, is the number of patients using hospice also increased significantly.

The amount that Medicare paid hospices in 2009 was over $12 billion dollars, according to the ABC News report. That’s billion with a “B.” That’s a lot of money. That’s a figure that gets attention.

ABC News, to its credit, goes on in the report to explain what hospice care is, then quotes Robert Field, a health management professor from Drexel University in Philadelphia. He says that hospice care “is used more and more because it’s worked out for many people.”

The story also quotes the Don Schumacher, head of the National Hospice and Palliative Care Organization, who makes the excellent point that “hospice still saves the government money.”

The ABC report concluded with two telling quotes:

“For every patient admitted to hospice, it saves approximately $2,250 compared to patients with similar illnesses not admitted to hospice care,” said Schumacher.

“The fact that the government is spending more on hospice care might be a good thing,” said Field. “That could be money we’re not spending on long-term care or hospital care.”

Yes, Medicare spending on hospice care has increased because more people are using hospice. More people are using hospice because more people know about it and have been told about its benefits. Because more people are using hospice instead of spending time in hospitals, hospice is actually saving the government money!

And now you know…

….the rest of the story!

 

 

 

The Death of a Spouse

A few years back, a man in his late 70’s lost his wife to cancer. With the help of hospice, he was with her to the very end of her life. Her passing was a gradual thing, not a sudden surprise. They had had time to talk together and cry together during her treatment and later when her death was inevitable.

Her life had been a good one. She and her husband were married for 57 years. They were able to travel together following their retirements. She was blessed with many friends. She had received excellent medical care following her initial diagnosis, care that extended her life by several months.

Still, her passing was a devastating event. The visitation and funeral were more meaningful and emotional than her husband had imagined they would be. The support of friends and family gave him comfort. The things they said about his wife reinforced everything he had known and felt about her.

The weeks immediately after her death were the most difficult. Tying up loose ends brought back memories of her life and death. While watching TV, he repeatedly turned to her empty chair to share a laugh or ask what she thought about something on a show. It took several months before he invited neighbor ladies to help him clean out his wife’s side of their closet.

Gradually, the old routines gave way to new ones. With help from church members and former co-workers, he established new social patterns. Having spent nearly two-and-a-half years as his wife’s caregiver during her up-and-down battle with cancer, he had shared much of her emotional pain. Although he survived, he still bore the sadness and sorrow that accompanies the illness and death of a partner.

Later, he was able to share grief with a lifelong friend whose wife faced a similar slow, steady decline and death. Just three years earlier that woman and her husband had provided love and support when his own wife died. He attended funeral home visitations of his contemporaries with a different perspective. Yes, he had buried both his parents decades earlier, but the loss of a spouse is a life event that has no match.

Now that he is in his 80’s, he appreciates every day of his life. He still keeps photos of his wife throughout his home. He enjoys a lifetime of memories, focusing on the good. He realizes that his life continues to bring joy and happiness and that family and friends are more important than ever.

When he is asked about hospice he says, “Those people are angels!” The hospice care provided to his wife was beyond his capabilities. The attention to his wife’s pain kept her comfortable during her final days. Hospice care made it possible for her to spend her end-of-life period at home, with minimal discomfort. The positive experience hospice provided to this couple affected the surviving husband’s attitude and made it easier to transition to the next chapter of his life.

If you have a friend or family member who could benefit from hospice care, please call Hope Hospice, based in St. Louis County, for information about how hospice care can help. 314-984-9800.

 

More On The Cost/Value Of Hospice

An amazing statistic appeared in a recent New York Times op-ed column. According to writer Susan Jacoby, “A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month.” The column also states “the average hospital stay costs Medicare over $6,000 a day.”

Those are startling numbers. If you have recently filed taxes, you may have noted on your W-2 form the significant amount of your 2011 income that went directly to Medicare. (And that amount is not deductible.) Whatever the amount, you would probably have preferred to have that money in your own pocket.

Consider the amount of money that could be saved by Medicare (and we whose contributions fund it) if those who are dying in hospitals chose to die at home, under hospice care.

Another note regarding the massive hospital bills that are accumulated by those who prefer to die connected to tubes and monitors in a hospital: families are often obliged to pay some of the costs that are not covered by Medicare, including the tab for certain drugs. Whereas patients on hospice care are not obliged to make additional payments to the hospice agency.

How do you know if your loved one would prefer to spend his or her last weeks and months in the comfort of home? (As opposed to being in a hospital.) You ask. And you ask early in the dying process, when the patient still has a grip on reality.

These conversations can be difficult to get started. But once the topic is addressed, you may discover that your loved one has thoughts and desires that have never been voiced. And, like with many such dialogues we conduct in our lives, they often turn out to be much less uncomfortable than anticipated.

Hospice care is a money-saver for Medicare when compared to the cost of hospital in-patient care. Hospice care can also be a money-saver for families of patients whose hospitalization coverage is less than complete. But the main concern of families and health care providers should be patient comfort. That is always the top priority of Hope Hospice staff and administrators.

To learn more about hospice and all the elements of care provided, call Hope Hospice at 314-984-9800. Or click on HopeHospiceStL.com.

Hospice Thoughts From The Web

Below are several comments about hospice care, collected from forums and blogs around the Internet. The comments reflect a variety of thoughts and concerns. We appreciate the input from all.

“This was a harder decision than I had anticipated even though we have always known my husband would not recover. Having finally made the decision, I find myself much more relaxed than usual.”

“The doctor has to certify that in his opinion the patient will not live more than six months, BUT that does not mean the patient must die in that time.”

“Whereas persons in home health care receive visits primarily from a nurse (additional services such as physical or occupational therapy are sometimes ordered), persons in hospice care receive the services of an entire interdisciplinary team whose area of expertise is end-of-life care.”

“Reframing the goals of care from cure to palliation often helps physicians accept a life-limiting prognosis. By referring a patient to hospice care you are helping to relieve their physical, emotional, and spiritual suffering.”

“The older parent who has been diagnosed with cancer may need help in negotiating her own end-of-life care. The mom may decide she is protecting her son by not informing him of her impending death and (hospice) staff may need to find the right approach to help her understand how essential it is that her son know she is dying.”

“Hospice care enables the individual and their families to experience the final stage of life together, in the setting most comfortable for them. In most cases, the person remains at home, close to family and friends while under professional medical supervision.”

“Hospice providers have consistently achieved very high consumer satisfaction ratings despite the reality that most of their patients die.”

“Even though the doctor thinks she has only 6 months, I have seen people live for years after being put on hospice. Because the care is so good people sometime get better for a while.”

“Some families who do choose hospice care often do so only for the last few days of life, and later regret not having more time saying goodbye to their loved one. To ensure that your family understands your wishes, it’s important for anyone with a life-limiting illness to learn all they can about hospice and palliative care and discuss their feelings with loved ones before a medical crisis strikes.”

“For those who are not familiar with hospice, it is both an approach to patient care and a philosophy focused on end-of-life care. The goal is to help those facing terminal illnesses deal with their pain, whether it is physical or emotional. The help includes pain management, counseling, helping clients get needed medical devices and the like.”

“If you have family members needing hospice care, please learn about it and help them get the needed care.”

These comments do not tell the whole story of hospice, but help illustrate some aspects of hospice care and those who provide it. We encourage you to learn as much as you can about hospice. You can get plenty of information from the Internet. You can also find out about hospice by talking to those whose family members have been on or are on hospice care.

Our staff is prepared to answer any specific questions you may have about the services offered by Hope Hospice, as well as your questions about hospice care in general. Don’t hesitate to call. We will put you in touch with someone who can help. Call Hope Hospice at 314-984-9800.

Find us online at HopeHospiceSTL.com.