Hospice/Palliative Takeaway

Written by on August 10, 2014 in Blog with 0 Comments

Last week, San Diego Rotary hosted a panel consisting of the presidents of three leading hospice organizations in San Diego county.  They were from Elizabeth Hospice, LightBridge, and Sharp Hospice & Palliative Care.   The three, who were all women, gave us a wealth of information.  And what they had to say applies nationwide.

The panel pointed out that under hospice care some studies show that people live longer than if there had been no hospice care.  So much for the oft-quoted notion that hospice care hastens death.

The speakers clarified the difference between hospice care and palliative care.  Hospice care usually includes palliative care, but palliative care, which alleviates pain and other suffering, is a new medical specialty that extends to all medical care, not just hospice.  However it was also stated that not all hospice organizations have a distinct palliative care program.

One of them made clear that to get hospice care paid for by Medicare, it is not necessary for the patient to die in six months, but a doctor must certify that “if the disease follows its normal course,” the patient will die in six months.   If the patient doesn’t follow the normal course and lives longer, another such certification is necessary.

One president asserted, perhaps rightly, that hospice is the only medical care that treats the whole family, not just the patient.  However I’m sure that many doctors, especially those in elder care, do try to take the family into account.

My takeaways from the panel are these points:

Don’t wait until the last minute to talk to a hospice organization.  Do so early, even before it is clear your loved one is on his or her final exit path.

  • Hospice organizations vary greatly.  Find one that both the family and the patient are comfortable with
  • Ask a lot of questions.  Can we call and get help at night?  How often will a doctor see the patient?  Can the patient go home?   Is there a difference between care in a facility, such as a nursing home, and care at home?
  • If there are long-term insurance payments coming in, can these continue at hospice?
  • If a patient should chose to stopping eating and drinking to hasten death (see my July blogs), all three panelists said they would honor that decision.   (Some hospices won’t.)

In closing I want to pass on a few really good quotes, not necessary about hospice:

  • In talking about the problems with our medical system, one person reported, “Dad was ready [to pass on], the family was ready, but the physicians were not.”
  • “Everyone wants to go to heaven, but nobody wants to go now.”

 

Bill

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