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- Jun 17, '11 by needshaldolCivilized, could not agree any more.
I have a nurse friend who believes Hospice is sort of "cult like" and I have to agree. But, again, for those of you out there thinking I am dissing Hospice, think again. It appears Hospice is needed "sometimes" but not "always" as it has started and again, in my humble opinion, to let the docs off the hook. They do not want to deal with it so they just pass it to the hospice who make a ton of $. Remember, "non profit" does not mean "low salary". Along with my "packet" of info, etc. about the program, was a beautiful little brouchure about donating $ to hospice. It is perfect. It is so easy to think of hospice when the loved one dies, and the hospice have gathered at the bedside "nicey nicey". I only wished I had had the guts and the time to take what happened to my mother with hospice to the papers. Well, now almost 18 months later, the almost 91 yr old is at the moment all dressed, make-up on, did the dishes, made her breakfast, made it up the stairs and is waiting for a ride to the senior center. She also folded the clothes in the basket that I leave with her. She needs to be needed, and have a purpose in life and now she has it. She hates my oven/stove as it is difficult for her to work, so this weekend she is buying us one she likes and can use. I give a huge THANK YOU to Hospice for opening my eyes as they almost killed her and would have gotten away with it, being hospice.
- Jun 17, '11 by nursemarionWell there is good and bad with anything. I could say the same about hospitals. Hospitals can be killers. Some of them I would not send the lowest of the low to. You all know the ones I am talking about. Hospice, home health, nursing homes, all have good and bad. That is why we advocate for our families- we do not want them to be the next victim.
I ask you not to assume that hospice=evil. It does not. The hospice concept is that the person is going to die, they have accepted that and are now going to focus on how to live well for the rest of their days. Many people do not need hospice. I agree with that. It is best for those who need support and symptom control. You get more than you do with home health, without so many hoops to jump through. Some people need only personal care or even family support until their dying day. It is a matter of determining what is appropriate.
I agree that hospice should be very limited in LTC. It is a duplication of services and should only be permitted in a case management role to make sure that patient gets the pain and symptom control that he needs. I worked casual at a local LTC facility and the hospice patients there seldom saw anyone from hospice. They were useless and did not even return our calls. Unfortunately it was a shaky company that marketed heavily in local nursing homes. I saw the darker side of it there and would never want to work for them.
If you have suspicions or concerns about any agency, you need to let Medicare know. They are the ones who are looking for fraud, abuse, poor care issues. They hold it all together.
Your mom is blessed to be doing so well at her age! I think so many people out there just need a good nurse behind them to advocate for them and help them navigate the system. I am a firm believer that a good nurse is worth her weight in GOLD.
- Jun 18, '11 by civilizedGod Bless your Mom who is doing so well. I just read that 50% of Hospices are for profit now, and they are growing. I worked for one that made 1.4 BILLION dollars profit in 2010. The largest Hospice in the country "suncoast hospice" made famous by the Terri Schivo case, was found guilty of Medicare fraud for patient brokering (paying hospitals & nursing homes for patient referrals) back in 1997 and medicare has been trying to re-coup 14.8 million since. At the same time medicare hired Mary Labak the administrator from Suncoast as a consultant. Medicare certainly has problems. Meanwhile, the families of the patients where hospice worked well, are donating money to them all the time. It's sad.
- Jun 18, '11 by needshaldolCivilized, you ought to know as you work hospice or worked hospice for years.
To think that there are kickbacks is a new thought for me!! Another poster said to call medicare. That is a bit of a joke sorry. There are too many cooks in medicare as in so many other fields that complaining of this in my opinion is like complaining that the weather ought to be better. I see the "medicare fraud" in the hospital almost every time I work. I work at a very good hospital (in top 5% CA) but that seems to mean not much other than less death? Less infection? We are a top heart hospital and alas now it seems we are a geriatric skilled nursing. Medicare bilking at its best. Old, demented, incontinent, unable to get out of bed patients, whom docs continue to treat with more and more procedures, blood transfusions, etc. So, in my opinion, medicare bilking. As for Hospice? If Hospice was so great, why is it not in an acute hospital like ours? Answer: because no medicare involved when someone on hospice, so no profit for hospital even if non-profit hospital which means little anyways. I work at non-profit hospital and I earn over 100K so one can imagine what top dogs are earning?
- Jun 18, '11 by nursemarionHome health is required to give the Medicare Hotline number to all patients to call and report any complaints. You can call 1-800-HHS-TIPS- the Inspector General office to report fraud or suspicious activity. There are strict rules and I am sure they apply to hospice as well.
- Jun 19, '11 by needshaldolYes CXG there are strict rules but but who is even going to think of calling when one is in such a stressed out situation and when we all believe health system and rely on them? It does not happen that easily. It is not just medicare and hospice but the U.S. health system totally.
- Jun 19, '11 by nursemarionI have to agree with you there. The whole system is so disillusioning. You have to wonder how it got this way. I suppose if you did not know what is right and what should be you would just accept what is.
- Jun 20, '11 by civilizedThe HHS Hotline number, don't bother. I not only called several times, I notified state agencies during abuse I was witnessing. Never did any investigator interview me. Never! HHS, they do not respond. It's hard to believe, but they do not respond! It sounds like I'm making it up, and it felt like I was in a nightmere while it was happening. I just discovered in 1 year, the Hospice I was thrown out of after reporting abuse, had 7 nurses who were hired and quit for my position, in 1 year. They all witnessed abuse and instead of risking their jobs, they found other positions and quit. As for the poor aides, there were 9 of them. They called everyone from the department of public health, health and human services, and even the National Hospice and Palliative care nurses org & National Hospice Org. I saw the letters they wrote, begging for help for these patients. It is still hard to believe because it was totally contrary to what I knew for 3 decades in nursing. And I witnessed it first hard. Certainly just as we see in politics on a daily basis, it is happening in healthcare, the compassion is disappearing. It's all about the bottom line. Greedy corporations. It's very sad.
- Jun 20, '11 by needshaldolCivilized....and others...... It appears that we get "sucked in" into believing. We go into this field wanting to make a difference and we find out we can only do that once in a bit. Civilized learned that the system is not protective of patients, but protective of their own salaries. It seems to take tons of years of experience to figure this all out, that a lot of people are being duped. And, yes, the bottom line......we all know what that is. I have a friend, a nurse, who had her father go thru 6 weeks torture, late 80's age, dementia, illness after illness, and the person he chose for medical charge had no clue and it kept going, blood transfusions, ICU, PICC lines, this, that, this that, and the docs made tons of $$$ medicare bilking. Finally, finally the person in charge decided "hospice", which of course took interview with social worker, 2 nurses, get the bed, etc. set up. Well, 36 hrs after he was home, he passes. All that $. He ought to have been on comfort care at the hospital and gone peacefully weeks earlier. People are just plain ignorant or most likely believe the health care personal. I have another friend whose loved one went thru lung cancer 15 yrs ago and came out good and got it again. I told her "it does not look good to me". She said, the docs said he had a great chance. Well, surgery Monday, complications, ICU, etc. etc. and Wed she pulled the plug. She felt guilty and I had to reassure her she did the right thing. During the few days of intensive care she said the docs kept telling her he had a good chance. Good chance? They kept at it (the guy also had mets) and as far as I am concerned, medicare-bilking.
I work acute med/surg/ortho/onc and I see this all too frequently. I am tired of tying demented, old, sick, never going to get better, people up so that they do not pull at their feeding tube. Cruel and to think that docs bill and earn $ for this? Not all, but quite the norm.
- Jun 26, '11 by showmegirlI was excited to see this post and started reading all of it, but when I got into it most of it was about fraud abuse and whistleblowing. I am a hospice nurse, my husband last year was on hospice for 7 days before passing away now with that company they came in admitted him received one call the next day then nothing until the day I called them to say he had passed. I as a nurse chose to work hospice and feel that I help my patients and theior families. No its not a typical 8-5 job there are many days that I may not get home till hours later due to admitting a patient or getting a call saying Mr Smith is doing bad and the family members wanting a nurse to come see them.you noticed I said them because not only to we treat the patient we are there for the families as well and at times they need a shoulder or a caring ear to have someone listen to them. I am on call and there are times my phone doesnt ring but there are many times it rings off the hook, some of it I can handle over the phone, like the ltc settings sometime they just need an increase in there meds and they know that hospice can get it to them faster but all my patients have my number and the direc line and they know they can call at anytime and talk to either me or another on our staff . I have gone to admit someone and find out that the doctor has not explained to them that there is nothing else they can do medically and sends them into shell shock I can see it in there eyes omg I'm dying when that happens I carefully explain what hospice is for, what we can do for them and their families, explain that yes while there is no more medical intervention for them this doesnt mean they cant get out and enjoy what time they do have. I will leave before admitting them and come back at a later time after they have had a chance to absorb it and talk with their familes. Hospice isnt something that you can force on someone, they have the right to say no even when the doctors have said they need this, it has to be their choice and the families. I am sorry for thise who have lost their jobs for reporting the abuse it's going to be the same for any job you hold, if your really wanting to work hospice then go to the smaller companies and see the difference, we do help with the end of life making it easier for them and the families and yes we deliver hospital beds but at the end we deliver so much more.