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    Category Archives: Hospice

    Letting Go – End of Life Realities

    It takes strong doctors to stand up to [the kind of verbal abuse that palliative care doctors have to put up with], to explain that courts and ethics committees have approved care that’s intended to reduce suffering, to point out that the patient’s own wishes are paramount. Perhaps they have to be stronger than we know. ‘The culture is changing … but it’s not changed yet.

    Have you sat down and written your “end of life” advance health care directives? It can be a difficult chore, to be sure. Carrying out your wishes, can be a difficult chore, too, especially for the palliative care doctors and hospice medical staff who will carry out your decisions.

    Some of these challenges were recently featured in an article titled Amongst Doctors, Fierce Reluctance to Let Go on the New Old Age Blog at the New York Times. Indeed, we live in a culture of medicine aimed at preserving life. However, when does such “medicine” actually get in the way and prolong biological life beyond what is desired by the patient?

    In addition to the medical culture of preserving life, the family of the patient receiving care can be a powerful force in the mix. Many times they do not want to let go, even though their loved one is ready. Add these three ingredients together – the medical culture, the patient’s wishes and the family’s fears of loss – and you have a recipe for conflict.

    The palliative or hospice care doctor is well attuned to the intentions of their patient and their wishes. Unfortunately, the rest of the medical community and the patient’s own family may be less attuned. In fact, they may be hostile at best and litigious at worst.

    I recommend reading the original article, as you will better appreciate the unfortunate tension thrust upon so many healthcare professionals in these cases. On the other hand, the lessons gleaned may encourage you to design advance health care directives with clarity and then communicate your wishes to your primary care doctor and family members now.

     Reference: The New York Times — The New Old Age Blog (March 29, 2012) “Amongst Doctors, Fierce Reluctance to Let Go

    Hospice: Medicare and Medicaid Profit Center?

    Healthcare lawsuits involving the various ways that the elderly can be taken advantage of turn up in the news on a daily basis these days. Why? Well, partly for political reasons and partly for the sheer number of egregious situations that have been created.

    As an informed citizen/taxpayer, it’s important to think about and understand the big picture. However, as a family member, it’s vitally important to remember them for the sake of your elderly loved ones.

    A new legal battle has begun to churn, as recently reported at Kaiser Health News. Yet another healthcare company is being accused of taking advantage of the elderly and their families to draw the greatest yield from Medicare and Medicaid coffers. Here a large company, operating across several states, is accused of actively recruiting and cycling patients through nursing home and hospice services.

    Such companies are compensated by Medicare based on the length of time patients receive care. Medicare picks up the entire nursing home tab for the first 20 days (after that the patient has to contribute), and conversely, if a patient spends too much time in hospice care, Medicare demands their money back since the patient was clearly admitted to end-of-life care under false pretenses.

    Here’s the rub: If you cycle between nursing home regimens and then jump into hospice care as early as possible (but not too early), Medicare will pick up the entire tab and for the maximum amounts, and that’s the issue.

    The legal battles, as well as the politics and economics aside, stories like these also demand a certain amount of attention since they could directly impact your family.

    If you have a loved one in need of nursing home and/or hospice care, it’s important that they find and receive that care… and that they not be abused by an uncaring system.

    Contact Meier Law Firm today and learn how you can protect the people you love.

    Laura K. Meier, Esq.

    Reference: Kaiser Health News (January 4, 2012) “Lawsuit Accuses Company of Fraudulently Cycling Patients through Nursing Homes, Hospice Care.”

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