How's the Hospice Business in this economy?

I live in the sunshine state, and our hospice has seen a huge difference for all of the reasons you listed. People seem to be staying up north instead of heading south for the winter. Hospitals are holding on to patients longer. Our local cancer center is, IMHO, holding on to people to continue treatments when there is no hope. The SNF's are holding on to their patients, preferring to keep them "skilled" even it's not appropriate. It's sad. Lately, when we do get referrals these poor people are very, very sick and don't have much longer to live. We just don't have enough time anymore to become involved and provide the holistic support that is core to hospice.
mc3

I haven't had a hospic case in over a month - which is very unusual. I generaly do all hospic - I work for a agency-all areas have slowed down. Most the work has been in LTC. I signed up with another company because of the slow down and will be working with TB and Aides patients at a research center. I use to be able to pretty much pick and choose where and when I wanted to work-not anymore.

I'm in California and our Home Hospice patients are coming to us later, and sicker. New Medi-Care guidelines have forced us to discharge some of our patients because they were not sick enough. The whole focus seems to be changing; rather than treat a human being, we treat as many negative symptoms as we can find. If we can't say enough terrible things about a person's condition, chances are we will have to discharge.

I got into Hospice to be a positive force during a negative event....that just isn't happening anymore. Now, rather than looking for ways to be of service, I find myself looking for even the tiniest sign of decline in order to keep the patient on service.

I love my work, but am beginning to hate my job.

I hear you about what you are talking about. I use to do almost solid home hospice. I know there is a difference between home hopice and facility hospice - I know hospice is hospice and there has been a change. Over all I do not know why - but after reading many threads and also being in the business - what confuses me is that people do get sick and die on a regular basis. I do understand not as many people have health care now due to unemploymen - and as with hospice patients perhaps their saving went down in the tube for care because their saving is almost nothing compared to what they had saved for.
This is a endless problem. I know that have worked in this industry for years and I choose to do it because I love my job. While I have worked in the industry for years and I now choose hospice as a choice - for the reason of lower patient ratio and burn out - I do know now the industry is changing.
Overall every person in the medical field is expected to and with caution I say this - work more. We have also worked more however the industry wants for us to keep their bottom lines the same if not more while patients that have no insurance or have lost thier savings to be the same for them.
I do not habor any ill will against anyone trying to make a living and working for it. I know by means of threads here other nurses are being burned out with having to care for a increasing number of patients and specificaly patients that normaly would have been transferred to other units.
I love my job and while it is getting tough I never thought it would be like this. I always "thought" my job was secure even with recession - and I never thought it would be like this. We can't fight against eachother - we also can't change what we know is the truth and is so hard to be changed. We stick together - and through it all we also will remember the differences betweens the rights and wrongs and we will together make a change not for ourselves indiviually - but we will through eachother because we are the strength.
Everyone feels your pain in all areas of healthcare. We will overcome and we will always stand by the difference between of what we can do - and the given oppertunities that these other forces that are confused and blinded by our realy situation and needs. We all stick together because we have one goal and that is to care for the patient. Example - My job is going to the nurse at the hospital - I can't do a thing about it. I know the nurse at the hospital is totaly confident - also not hospice and in most cases that nurse has a jellion other types of patients to care for. and their load is being increased and hiring freezes are taking effect. I am thankful we have each other and as for what to do - Well I don't know. Time will tell.