Hospice: What it's good for, or What's it good for?

 I have a friend whose husband was diagnosed with the deadly disease of pancreatitis. During his last hospitalization, the tremendous level of his pain was thankfully alleviated through hospice services. His wife viewed Hospice as almost a divine intervention which ultimately ended his agony.

  My husband's terminal neurological disease impacted his ability to sleep or rest, as he needed to call out for comfort of some sort every few hours, during the night time. The doctor at the Vermont Hospital arranged for him to have someone attend him throughout the nighttime hours, so his callouts would not disturb the sleep of other nearby patients. That was an ideal solution until other patients were no longer nearby, and so the overnight attendance was withdrawn. He missed that service and wished it could be reinstated. The best solution the presiding  doctor could offer was to submit him as a patient to Hospice. A representative from Hospice showed up to enroll him, a young woman who was friendly, talkative, telling me details about her baby son,  and obviously eager to enroll him as a patient. We did so.

   Unfortunately, the hospice services did not allow him to have the nighttime attendant he had so wanted, but we kept him on anyway.

  Not too long afterwards, an aide left him poised on the edge of the bed while she turned away to get some supplies, and he rolled off onto the floor, hitting his head and opening a gash, and probably losing consciousness for a time. He was taken by ambulance to the nearest hospital. In the early hours of that morning, I received  a telephone call from the neurologist who had been called in to assess his condition. He asked me if I wanted him to have a CT Scan of his head to see if there was any internal bleeding. I said yes, and the scan was done.That was the beginning of the end of his being a hospice patient.

For Hospice is a comprehensive holistic program of care and support for terminally ill patients and their families, with the focus on palliative care for pain and symptoms instead of care aimed to cure the illness.The neurologist said Dave's scan would not fall under coverage by hospice, and I said then remove him from hospice. He complied.

The rep from Hospice showed up, asking about the issue. She was curt, almost hostile. I explained that falling out of bed was not a symptom of his illness, but an accident, and I supported my action; if that was inconsistent with her hospice affiliation, so be it. As she was leaving, I asked her how her son was; she answered in one word, as she walked out the door---"growing" was all she said.

 My take on hospice would be that it is a business, founded on the principle of keeping the terminally ill out of the hospital, and medical expenses, primarily unnecessary as not life-prolonging, to a minimum. Different states have different rules for hospices to abide by, as do differing localities. I would say that hospices operate about the same as any franchise, with the ability to choose one over another. Experiences vary, as per those cited above. But Hospice is not certified by angelic sources to descend on the suffering  and manage their entry  into the great beyond.