April 27, 2017
This is an article written by Jenny Buckley, RN, our Community Outreach Coordinator. Jenny writes an insightful blog, HOPEspot. We are cross-posting with her permission. I’ll always be passionate about promoting awareness for hospice. Often times, when a “celebrity” or well known public figure dies, I’m always curious if hospice was involved. The last most notable example that I can recall was Elizabeth Edwards, as she succumbed to her battle against breast cancer. In death, as in life, Ms. Edwards took her unfair blows with grace and dignity and chose to have her life end at home surrounded by family. I wish the collective “we” talked more about her choice for that than about the poor choices her ex-husband made prior to her death. As I’ve said many times, I often have the privilege of being the first one called to talk to patients and families about the benefit of hospice. Some are receptive, many are not. Today, I really wish I had the opportunity to speak with former President George H.W. Bush and his wife, Barbara. I adore and admire this couple and would like them to have the opportunity to consider hospice. And I’d like to share with you the importance of this “imaginary” conversation, regardless of your politics- please. I’d like you to pay attention because former President Bush’s situation may turn out to be similar to someone you love. George Herbert Walker Bush was the 41st President of the United States of America. Prior to his […]
August 23, 2016

To Recertify or Not Recertify?

To recertify or not recertify? That is often the painful question hospice interdisciplinary teams (IDTs) must answer. For me, it is important for those outside of the industry to understand the challenge of the recertification discussion and the diligence and care with which the Weinstein Hospice IDT takes to answer the question. To be clear, when a patient is admitted to hospice, the referring physician signs an order stating that if the patient’s illness takes its usual course, the patient is likely to “expire” in six months or less. This verbiage comes directly from the language in the legislation that made hospice part of the Medicare benefit. I spend a good part of everyday explaining to patients and families that the six month “term” is just a guideline and not a hard and fast rule. It is a guideline. More specifically, and what many people don’t understand is that within the first six months and beyond, hospices are required to demonstrate the need for recertifying the patient at set intervals: the first 90 days after admission, the second 90 days, and then every 60 days thereafter. To recertify a hospice patient, the hospice IDT must be able to answer the following three questions with concrete evidence: does the patient still have the terminal diagnosis under which he or she was admitted? Is the patient seeking any curative or aggressive treatment for said illness? AND, has the patient demonstrated any form of decline since the last certification period? It’s in that last question that a committed IDT […]
April 17, 2016

A Life Worth Living

A neighbor of mine flew to a clinic in Switzerland to be euthanized. She had moved to Israel 18 months earlier to be close to her sister after being diagnosed with a malignant brain tumor. What saddened me most was the extent of the hopelessness she must have been feeling. Those of us who have worked in hospice believe that hopelessness is related to fear — of the unknown, of pain, and of being a burden to others. Hospice’s goal is to try to alleviate these fears. We strive to recognize the source and treat the pain, be it physical, emotional, or spiritual in nature. Our care however, is not only for the patient. We do all we can to support the patient’s family and friends so that they are better prepared to deal with the caring needs and, eventually, the loss of their loved one. Our hope is that by alleviating these fears the patients are able to spend meaningful time with those they love, so that they feel that whatever time they have left is worth living. One of our patients said that the best days of his life were the days he spent in hospice. He had a terrible childhood and was alienated from his family. He said that for the first time in his life he felt loved. If he had been euthanized when he was first diagnosed with cancer he would have died never having known what it is like to be loved. While this […]
April 17, 2016

Increased Scrutiny by Medicare is a Good Thing

As the director of a small non-profit hospice in Atlanta Georgia, I am concerned about the practice of hospice in this state. I am grateful for the increased scrutiny that we are under by Medicare because I am witness to the abuse of many of the larger for profit national chains whose marketing practices are questionably ethical. These practices contribute to the skyrocketing cost of medicine. The hospice lobbyists claim that it is much cheaper for the government to provide hospice care at the end of life rather than incur the costs of hospitalizations. This is absolutely true. However, this also provides the perfect foil for many of these providers to abuse the system. I commend MedPac’s (Medicare Political Action Committee) recommendation to investigate the marketing practices of hospices. I am appalled at the way some hospice representatives walk into assisted living facilities and promise the staff that, if they refer a minimum number of patients, they ( the hospice) will provide them with a fulltime nursing assistant. For assisted living facilities meant to provide assistance with activities of daily living this is an offer that is hard to refuse (and seldom is). Those of us who do not offer this are at a competitive disadvantage. This takes the choice away from the families because the assisted living facility will influence the referral based on their needs, not what is in the best interest of the patient/family. I say go OIG (Office of Inspector General), look closely at the conflict […]