Hospice care - page 5

I have worked in Hospice for 29 years. It has changed over time, some for the better, some no so much. Mostly I worked in small community based organizations, but recently moved and was offered a... Read More

  1. by   needshaldol
    CXG, missed that post. you are 100% correct. I find that docs are in either denial or just plain not seeing the "family" picture. It is a terrible situation indeed. When my dad was put on hospice, we moved him out of skilled nursing (who can afford that?) and into a board and care at 1/2 the cost and better care. I took him OFF hospice. Why? Because the board and care wanted 1K/mo for hospice. They were not going to do anything different with his care. I was in shock for a moment and fixed my shock by "off hospice". So for 1K more/mo he gets a hospice bed, a visit here and there, and meds that medi-care would have paid for anyways. On hospice, they do not call 9-1-1. So my dad was there 2 months and he did get his 9-1-1 call once. That is when I stepped in and put him on comfort care that day at the hospital. 48 hrs later he went to heaven not with the help of hospice. Of course, every persons situation is not the same. My dad did not have cancer or pain. So it was not a medication issue at the board and care.
  2. by   nursemarion
    Not sure what state you are in. The hospice benefit pays for hospice, not the patient. Unless you have private insurance and have co-pays, etc. The board and care wanted YOU to pay for hospice? Makes no sense to me. Did they have their OWN hospice that was not certified or something? I don't understand.

    I know there are many people who only need personal care until the end. I do not dispute that. There are also many people who wish to fight to the end (911 call). They wish to "rage against the dying of the light". I think that is fine. No one has the right to judge another's feelings about dying. It is a personal experience, perhaps the only one that sometimes, just sometimes, we have a teensie bit of say about. To fight or to accept, to be compliant and try to do what is best and hang around as long as we can, or to cheat and be non-compliant, the who cares we are going to die anyway approach. If we know we are at a terminal point at least we can choose how to go out. And that is freedom, that is how it should be.
  3. by   needshaldol
    I am in California and board and care is private pay. The charge for my dad was $4500/mo which was very reasonable for this location. And yes, they wanted 1K additional just for being on hospice. I think they think that they will have to do more care? And yes, that 1K is private pay. Maybe the board and care needs some sort of license for it? I have no clue. I just took dad off hospice and no problem. I believe that one of the most important things is for someone who is dying or in pain, to have the best advocate chosen. My dad chose me, probably because I am a nurse. My goal was to keep him comfortable and not let any doc talk to me about peg feedings, etc. I see this in the hospital that I work at, when families do not "get what is happening" and the doc helps them by keeping the patient alive longer for more pain for all. I did exactly as my dad would want and I only hope someone will do the same for me if needed. I think the biggest problem in our system is that there is too much denial and docs are afraid of telling families what is really going on.
  4. by   civilized
    The National Hospice Foundation is run by ******, she is also the CEO of the largest Hospice in the country. That Hospice was charged with Medicare fraud while ***** has been running it. Medicare has been fighting to get it's money back for years now. So what does the government do, they hire ***** to sit on an senate advisory panel for Hospice issues....... craziness, like much in healthcare, education, etc etc etc
    Last edit by Silverdragon102 on Jul 3, '11 : Reason: name removed
  5. by   needshaldol
    That is typical American (and I am happy to be an American) behavior. Pay and Pay out to the louts and then hire them? I guess they know ***** knows what to do? CEO of hospice? See, non-profit means little. Good accountants in the whole business of health care. I am sure that ***** would not be happy if we got some sort of socialized/type medical here as her salary would be cut by 75%. It would not surprise me to learn that her salary along with bonuses is easily 1/2 mil/year. Maybe she donates to hospice? ha
    Last edit by Silverdragon102 on Jul 3, '11 : Reason: name removed
  6. by   needshaldol
    civilized, I googled ***** and no results.
    Last edit by Silverdragon102 on Jul 3, '11 : Reason: name removed
  7. by   civilized
    Go to the "Hospice Patience Alliance" website, they have all kinds of facts about ***** since she was the CEO of the Hospice where ***** was. They also have information about her on the National Hospice Federation website. She is also the past president of NHPCO. I found out about her doing research on patient abuse, her history was questioned by the senate elder affairs committee.
    Last edit by Silverdragon102 on Jul 3, '11 : Reason: names removed
  8. by   needshaldol
    This is getting a bit "uncomfortable". I googled that woman who has gotten "awards" and found a post of mine regarding some of my opinions of hospice. Not a happy camper. Think big brother is watching?
  9. by   civilized
    I know big brother is watching this site. The Hospice that I have a lawsuit against after they fired me for being a whistleblower, has sent me threatening letters that they will sue me for slander if I mention their name. Wonder how they know it's me...........
  10. by   needshaldol
    Big Brother has Big Money and knows it all if it wants to. Get your ducks in order before taking on a high-profile organization, or rather a corporation that gives the impression that they are all about the person. Most people will look to them as the good guys.
  11. by   civilized
    My ducks are armed and ready. I have charts for months documenting patient abuse before I even started working there, I have charts documenting a patient crying in pain, nursing home staff documenting patient in pain over a 3 month period and calling the Hospice with replies from the DON & Clinical director. "Patient not in pain, it's a behavioral issue" followed by a dx of fractured bones from falling out of bed. I have documentaion of wrong medications given, patients being admitted after MD's note in chart "let's try to find a way to get this patient on Hospice to help facility" and on and on. The nursing home was pretty bad, but it was the administration to blame there as well. The staff was just totally unqualified. The nurses hadn't had training in many many years. They didn't even know basic first aide in some cases. The 11-7 nurse was a young kid who brought her 7 year old son to work at night and he slept on the floor at the nurses station. Very sad all around.
  12. by   needshaldol
    you NEED the best lawyer. I have been on a medical trial where I believed the patient. She was suing a nurse who was represented by the hospital. The patient lost. Most people do not want to believe such poor care exists as then they have to think about their loved ones or themselves and no one wants to. Was this place accredited? That is another issue. If so, it "passed" for medi-care, medi-cal, etc. I wish you luck. And even if you do not win, you win by letting others know that things do not work in healthcare as they may believe. My dad was at a supposedly "top skilled nursing" for three weeks before I yanked him out. In three weeks he was filthy, feces in his nails, dirty clothes, infection in his mouth because they did not take out his partial at night, and was put in bed medicated with his heavy shoes on. I was disgusted and his doc said "that is a great place". So, the doc was clueless. I hope to see you win and see this in the papers. I wish I had gone to the papers regarding how my mom was almost killed on hospice. They saw an old woman in pain (no illness) and sedated her where they told me she had a stroke and "was gone". That was 18 mo ago and she is right now sitting in my rocking chair reading and comprehending a book!