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There was a recent post, with AlvaDeer commenting about the role of hospice possibly changing and not like it once was, but I cannot locate that post. Anyone care to comment on what hospice 'really' does now or what may have changed?
I'm not an American but I can give you what I've gleaned from my time on the forum - Hospice was founded on the principle of providing compassionate care and guidance for those facing the end of life but like anything else in healthcare/eldercare it has become a big business complete with competition and bureaucracy, and unfortunately the compassion seems to have been forgotten by some in the industry. Bottom line is that not all agencies offer the same level of caring and of course not all employees who are there do either, caveat emptor.
More and more Hospice are now "for profit". When the Hospice I selected and Volunteer for became for profit I told myself that I would stop Volunteering if I heard that it had effected patient care. It has been a couple of years and I have not heard that there has been an impact on patient care.
When I chose Hospice I got all the supplies and equipment that I needed to safely care for my Husband. That still happens I got support from staff, that still happens. I got medications delivered and if he needed another for an infection or rash those were delivered as well, that still happens.
What does not happen on Hospice is providing curative care. Hospice is comfort. If hospitalization is needed that can be done on/with hospice. For example if a patient cuts themselves and needs stitches Hospice can authorize that. A patient can be discharged from Hospice and then come back on service. The discharge can be the result of a patient not declining the way Medicare guidelines are established or because the patient wants to try another curative treatment or any other reason. And it can be a result of the patient or family not liking the particular Hospice. They can select another and the new Hospice will work to get the patient transferred. Just like any other medical service you read reviews, you do your research, you interview a few and if after all that you are not happy you can select another OR return to your old doctor and resume standard care. YOU are the one in charge of medical decisions and if you do not want "life prolonging" medical treatment you decline any suggested.
The criteria changed a few years back. More people were able to get Hospice who wouldn't have before. My Hospice was connected to the Hospital.
I think the problem is that families do not understand what Hospice is. Your not suppose to get better even though some people do. Its an end of life service. The person is going to die. The intake nurse should tell the family what services are provided. The family member should have someone with them when speaking to the nurse. We all miss things. A nurse will come 1 or 2x a week and should be on call 24/7. An aide more often for bathing but check to see if can get xtra hours. If home Hospice, the family does most of the work and someone needs to be the patient 24/7. If you don't like the Hospice you can change them. Don't like the Nurse or aide, request someone else. Hospice does not dope the person up or starve them. Morphine is given for pain and sometimes the person gets enough to sleep thru the pain. Food and water are stopped because the body is shutting down, first sign, lost the ability to swallow. It does more harm to feed them. The Nurse should be your friend and answer any questions u have. She also orders the incontinence supplies, any durable equipment needed and prescriptions needed for hospice care. The patient may suffer from anxiety, they will be medicated for that. Hospice is comfort care. No patient should be in pain. Like life you get good people and bad people. You always need to be an Advocate.
What has changed is that they have gone from what they were when they came from across the pond in the UK, when they had a mission to help the dying. They are now very much a part of the military industrial complex. They are in fact the new darling of the Hedge Funds. Never a good sign. Medicare pays enormous amount monthly for hospice. This used to provide individualized care plans for those dying at home, dependent on their individual needs. Not any more. You now get about 3 bedbaths or assisted bathing per week. One RN per week. A call from a Social Worker. A call from Clergy. Equipment needed (bed and bedside commode etc). And the medications. If care is needed by nursing personnel you will get also things like wound care, etc. That's about it. I have many RN friends who worked in hospice "when". They have all stopped working for them as they are too limited. Families are told to hire their own 24/7 care. And hospice does it's stop by program, saving as much money as they can for profit. There used also to be "in facility" hospice. Rare now as hen's teeth. If you google or search engine "changes in hospice", "recent changes in hospice care" you will find many articles on the subject.
Wish you good luck. Just saying. Get all you can. This is currently ALL WE HAVE and the best we can get, but it has gone from "a mission of care" to "a for profit" conglomerate. My opinion only, but if you google you will find the evidence well spelled out.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
When the Hospice I selected and Volunteer for became for profit I told myself that I would stop Volunteering if I heard that it had effected patient care.
It has been a couple of years and I have not heard that there has been an impact on patient care.
When I chose Hospice I got all the supplies and equipment that I needed to safely care for my Husband.
That still happens
I got support from staff, that still happens.
I got medications delivered and if he needed another for an infection or rash those were delivered as well, that still happens.
What does not happen on Hospice is providing curative care.
Hospice is comfort.
If hospitalization is needed that can be done on/with hospice. For example if a patient cuts themselves and needs stitches Hospice can authorize that.
A patient can be discharged from Hospice and then come back on service. The discharge can be the result of a patient not declining the way Medicare guidelines are established or because the patient wants to try another curative treatment or any other reason. And it can be a result of the patient or family not liking the particular Hospice. They can select another and the new Hospice will work to get the patient transferred.
Just like any other medical service you read reviews, you do your research, you interview a few and if after all that you are not happy you can select another OR return to your old doctor and resume standard care. YOU are the one in charge of medical decisions and if you do not want "life prolonging" medical treatment you decline any suggested.
I think the problem is that families do not understand what Hospice is. Your not suppose to get better even though some people do. Its an end of life service. The person is going to die. The intake nurse should tell the family what services are provided. The family member should have someone with them when speaking to the nurse. We all miss things. A nurse will come 1 or 2x a week and should be on call 24/7. An aide more often for bathing but check to see if can get xtra hours. If home Hospice, the family does most of the work and someone needs to be the patient 24/7. If you don't like the Hospice you can change them. Don't like the Nurse or aide, request someone else. Hospice does not dope the person up or starve them. Morphine is given for pain and sometimes the person gets enough to sleep thru the pain. Food and water are stopped because the body is shutting down, first sign, lost the ability to swallow. It does more harm to feed them. The Nurse should be your friend and answer any questions u have. She also orders the incontinence supplies, any durable equipment needed and prescriptions needed for hospice care. The patient may suffer from anxiety, they will be medicated for that. Hospice is comfort care. No patient should be in pain. Like life you get good people and bad people. You always need to be an Advocate.
Not any more. You now get about 3 bedbaths or assisted bathing per week. One RN per week. A call from a Social Worker. A call from Clergy. Equipment needed (bed and bedside commode etc). And the medications.
If care is needed by nursing personnel you will get also things like wound care, etc.
That's about it.
I have many RN friends who worked in hospice "when". They have all stopped working for them as they are too limited. Families are told to hire their own 24/7 care. And hospice does it's stop by program, saving as much money as they can for profit.
There used also to be "in facility" hospice. Rare now as hen's teeth.
If you google or search engine "changes in hospice", "recent changes in hospice care" you will find many articles on the subject.
Wish you good luck. Just saying. Get all you can. This is currently ALL WE HAVE and the best we can get, but it has gone from "a mission of care" to "a for profit" conglomerate.
My opinion only, but if you google you will find the evidence well spelled out.