NO, no, no. The new 'healthplan' is about rationing and saving money by not saving lives. You are now a ward of the state. They will decide whether you and loved ones live or die. This is what Obama and Pelosi have dumped on America. Deal with it if you voted for those crap holes, who btw, won't be on the substandard care outlined for you, nor will their families, that they mandate for others. There will be death panels people, they simply won't be called such, possibly rationing boards, as in UK, or other.

Suckers. You just lost your freedom to seek treatment. Now you will be told "no", time to accept death.

Idiots.

I am totally in favor of people taking treatments for as long as they decide. Even if this means up to the point of death. This is a personal choice and should be left up to a person's discretion. But I do believe that hospice care should be limited to those who are dying and cannot be helped either paliatively or curatively through additional treatemts. Hospice should be limited to those who have accepted death and need assistance in working through end of life needs and decisions. I believe the following statement from the article is a key thought:

Some fear doing both curative and palliative care will muddle efforts to get patients to embrace the hospice philosophy emphasizing quality of life. "It could be great," says Terry Berthelot, an attorney with the Center for Medicare Advocacy, a Connecticut-based patients’ rights group.

But it also "may make dying more difficult, because some people may be chasing after cures instead of what hospice is about, to say ‘thank you,’ to say ‘I forgive you’ — that emotional work."

In my humble opinion Hospice should be done away with.  It's just a place for people to be shuttled from a hospital to another building to go there and die. 

What's "curative" and "palliative" mean??

Hospice being a non-profit organization filed some pretty hefty charges to Medicare for the six weeks that my Mother was under the program. I was pushed by the nursing home staff into the idea of signing up w/hospice for my relative.

I explained to staff that I felt that was why my relative was in the nursing home facility for that very same care. As, I saw that good care was lacking in the nursing care facility by staff, I relunctantly signed with Hospice.

It became a nightmare of what Hospice wanted...not what was best for my relative. Information was with held from me, as the guardian. I had to fight to get the right care for my relative.

After six weeks, I fired Hospice. I realized that their total program was to push for death and not to do what was right for the patient as they needed it. The lack of care from the assigned nurse from Hospice quickened the agony that my relative fell into because of that period of time of improper care.

I was totally unprepared for the callousness in the care for a terminally-ill person. I know that my relative probably would have had a more peaceful and less painful ending of her life, if she had had good care from the nurses in the nursing home to begin with.

I thought that Hospice would be a beneficial plus for her. With that lack of care in the facility, she had skin breakdown from improper meds and then rashes which led to bedsores. None of that should have occured, if staff had paid attention to the charts.

If, the doctor had read the chart, he would have noted that the patient was allergic to what he prescribed. If, Hospice had cared, they would have conceeded to my attempt at admission to a hospital for my relative. They fought me all the way.

By the time, my relative was admitted to the ER, she was in very serious condition...all due to the lack of good care first from the nursing home and secondly with Hospice. I regret my decision to ever have signed papers with Hospice.

I have heard that people find solace with Hospice. I personally find the program to be useless. (Buyer beware!)

I had Faboo insurance but when my late husband entered the first hospice program they would not give him blood transfusions because they did not consider them "palliative care." We lost all control on his life. They wanted to run the whole show. SO he dropped out of hospice,walked around with a Hemoglobin of less than 8 and continued working , golfing etc. We finally found another hospice program that would give him transfusions. He was only 42 when he died from Prostate cancer and owned his own business. He wasn't ready to just lay in a bed and get snowed on his medication until he died. Shop around. People should be able to exit this life on their own terms. I will not ever endure the chemo and radiation treatments, transfusions and heavy dose narcotics like he did, but that is my choice, he made his choice. We should all have a choice.

Exactly as I expected; 9 responses on a subject that eventually affects most, if not ALL of us. No one likes talking about death, but it is a proven fact that people who DO plan, accept death much more placidly.

I'm a retired nurse who worked some (coverage) Hospice, we had it for my Pop more than 20 yrs. ago, & also, I'm a current volunteer. Hospice's mission statement is care for the terminally ill. I agree about covering people who are awaiting a transplant esp. as MOST are younger. But adding more than palliative care in my opinion does not do most patients any good as to go through the steps of dying, one MUST accept them to have a peaceful death. It takes time & some "work" on the part of the patient, so there is where the nurses, aides, & esp. volunteers come in. Regular medicine has NO time to listen critically although I wish it did.

Hospice is WONDERFUL & I hope to have it for myself when the time comies. Do know however, that one doesn't necessarily NEED a family member to be a caregiver. My 1st. patient was a 60-something woman with terminal bladder cancer. Her church had setup a schedule of coverage so someone was there with her almost all the time. And although I have some issues with non-liscened caregivers giving pain meds., it worked wonderfully. Hospice is terrifically adaptive & won't "throw" you out if you should live past the 90 days of diagnosis that is required to participate. Some patients have lived at least 3 ys. (my Aunt-emphasemia).

With 78,000.000 boombers hitting "critical mass" soon, it is something that will have to be refined & promoted, but I have been "sold" for over 20 yrs.

Not sure how I feel accept for one thing. We each should have the right to make our own decision when it comes to living and dying when your talking about quality of life. I know there are several senarios that I have told my wife please don't let me linger if there is no hope and no qulity of life according to me. I am not sure if all of this is going to a bad thing or a good thing. Whatever it ends up, it should be the right thing according to the person or family it effects.

I think this is a wonderful idea and I should know. My father is facing this decision this week. He needs a liver transplant and no it is not from alcoholism. Hospice told him he must stop all treatments and give up. At first he agreed but then he said," No I want to keep going and I'll do it myself." He and my mom sat down and made the decison to let Hospice go so he could continue treatments. Thank God he only needs Tylenol for his pain right now. Hospice is a wonderful organization but sometimes that liver will come with just a little more patience and people should be given that chance. He has been on the transplant list for 10 years at Duke. I am proud of him for not giving up just because Hospice and Medicare say he should. Bless my Dad and I pray he is around another year because 1 year more is 1 more year to love each other.

i do not usually respond to articles but this one hit a nerve. i am for this part of the bill. i am largely not in favor of the health care bill, let's get that out first. i am a health care worker who has had multiple encounters with hospice care in massachusetts. i am not impressed. alot of people are not ready to die. that is a tough decision to come to. hospice care, as it stands, is a great concept if one is ready to die. it is not for people who have not come to terms with their imminent deaths. hospice "helps" the person along. the passing can come in as little as 3 days once they start this regimen. maybe that should be investigated as part of why people don't choose hospice until the end. hospice hastens the end. they medicate, medicate, medicate and keep increasing the medication until the person passes. this is great for someone who is ready and that is what they want, it is not great for someone who is not ready for that. i had one hospice nurse get mad and threaten the family that she would terminate hospice if they continued to give their loved one something to eat when requested. the doctor was called and he wrote an order giving permission to feed the patient. how sad, i thought eating was a basic human right.

most cancer doctors are up front with their patients and will tell them when all options have been exhausted. alot of people are just not ready to give up and will keep reaching for something to cure them. this is their right. who has the right to tell them they can't do this. all a medical professional can do is give someone enough information for them to make an informed decision, they cannot tell them what to do. they have to follow through on what the patient wants unless it is outrageously dangerous. that is patients rights. hospice philosophy, right now, takes away patients rights and makes the hospice a death squad. let's take away the hospice' right to do that and give the rights back to the patient.

hospice is great for someone who has reached the peace and acceptance of their imminent death. it will help the along in the process. but it is not for someone who is not ready to accept and many times hastens death for people who are not ready. that is traumatic for the families and they are the ones who are left with the questions and doubts as to whether it was appropriate.

Many folks on Hospice end up like my Mother did by ultimately dying from something other than their diagnosed disease. While keeping her comfortable at the nursing home, she caught a cold which quickly developed into pnuemonia. I was forced to make the dreaded decision on whether to take her off Hospice care to treat the pnuemonia or to keep her in the Hospice program and let her die from something that had nothing to do with the original diagnosis that put her in Hospice in the first place. It was the toughest decision I ever made and one that I will always question for the rest of my life. Did I do the right thing? I'll never know for sure.

Hospice service varies according to those who offer the service. I think it's important to remember that nothing is mandated by beaurocrats, unless they have been influenced/lobby'd by some group to do it. Influence no longer means constituents needs or desires, it means money. Hospice initially began as a service to help people transition from active medical/surgical treatment to supportive, terminal(end of life) care. Now, healthcare centers have realized the profitability of Hospice reimbursement and now Hospice services are popping up all over the country. This includes the shift from helping a person die as confortably as possible, preferrably in their own homes to building Hospice houses, or centers for people to go to in order to die. It is not unusual to see nursing home patients transferred to Hospice houses in their last days. Our small rural town of 8000 people now has 4 different hospice providers competing to provide "service" to the terminally ill, and Alzheimer patients in our area. I am enough of a skeptic to realize that the basis for this is not the primary concern of comfort for the dying patient. By extending the focus to include the continuation of "curative or maintenance care", such as chemo, dialysis and organ transplants, the cost will go through the roof. The majority of recipiants of this care happen to be older. The money for their healthcare comes from the government. That is Medicare, Medicaid, Medicare hospice. This "new" expansion in service will have a cost greater than what we have now.

Nothing I've said thus far calls the care givers inhumane or unethical. As a rule, all the hospice workers I know are caring and nuturing people. Many families have true needs in caring for their ill loved ones. Some families are too busy to care for their terminally ill family members. Some find the whole situation just too inconvenient and uncomfortable. (you want me to clean up my loved one when they have soiled themselves?!) There are exeptions of course, yet families could do more than they do. In many cases, the local church would be very happy to try and mobilize volunteers to help sit with someone and help provide comfort care. Primary care providers need to be doing a better job of being their for there dying patients. As Physicians have become employed by "health systems," personalized care has sufferred. So now, we find it more convenient to provide some program to do what we took an oath to do. This includes the family as well.

I am an RN that has worked in Home Health Care for 20 years and therefore often work hand-in-hand with Hospice agencies and I am appalled at what some of these comments are. Not only have I worked with various Hospice groups but during the last 2 years I myself sought Hospice care for my Mother, who passed away in January, with Alzheimers Disease. The Hospice nurses, social workers, ministers, and aides were a blessing and were wonderful with Mama. Thank God my Mother was a wise and wonderful business woman and had saved up enough money to allow me to have 24 hour caretakers with her also and keep her at home since I have to work. What I want all of these "uninformed " people to understand (and I try and discuss this with families I work with on a daily basis) is that when the time comes that there is no improvement and only decline most families are not able to give the needed daily care to these loved ones, especially elderly spouses and Hospice can offer the most care available. Unfortunately many of these same people are under the misconception that signing up with Hospice is a "death warrent" for the patient and now I can say to them that I have personally been there and this was my experience.

To "Suckerfish" all I can ask is if you felt every one was so incompetent and was purposely woking against both you and your family member you had guardianship why didn't you remove her from both the nursing home and the Hospice care immediately? I'm sure that these miserable people were not the only ones available in your area. I would also like to point out that even with my being a nurse my Mother died with 3 pressure ulcers because we could not overcome her severe weight loss and malnutrition even though the Captain of my ship, my certified and trained nursing assistant that took the most care of her, fed her liquid feedings continuously and changed the dressings (using every wound dressing that I had access to from work) twice and sometimes three times a day and turned her every two hours (I know because I checked on her at different times during the day and night).

The point is my experience with Hospice and my fiends experiences have been considered a God send and I am now passionate enough about it to make it one of my missions in life to educate all of those that are so completely uninformed about their functions and benefits. I also explain to our patients that there comes a time when Home Health just can't offer the services that are needed and we refer the patient to Hospice to have those needs met if they are accepting to the services.

All businesses and companies differ as does the medical field. I've had Doctors that I did not like or their office staff's attitute ran me away so I changed to another one, for the life of me I don't understand people that taste one vegetable and from then on hate all vegetables, it certainly leaves you living in a tiny little bitter world. Everyone is going down this road sooner or later, help is out there, embrace it.

I think it would be more beneficial for people to be educated on what hospice care really is and the dying process. A seperate transitional program for people who are not ready to stop more agressive treatments but have made themselves a DNR(do not rescuscitate) may be beneficial for those who are not quite ready to stop treatment and change to comfort care. these programs are already available in larger cities and they call them palliative care or also transitions care, most average and smaller areas and hospitals are to limited to make specialty programs available. However, it is important to remember that medical ethics statement is "to do no harm", all medications and treatments have risks/side effects and those with terminal illnesses as well as people of any age with multiple medical problems reach a point in their medical care where the treatment is no longer beneficial and the risks/side effects can be more harmful than not providing any treatment at all. With that said, it is important to remember that doctors, nurses, social workers, supportive staff , and all those that work in healthcare regardless of location (hospital, skilled nursing facility, adult family home, hospice, etc.) are in fact humans who have their own beliefs and morals. Due to the fact that humans are not perfect, in any level of care if you are not receiving quality care for yourself or loved one, speak up. It is never appropriate to give medications or withold treatments to try and speed up the dying process or administer agressive /invasive treatments that cause more side effects/harm than benefit to prevent death. Quality hospice care is providing the patient treatment with comfort as the goal during the dying process. Since we have people in hospitals and other facilities of care the dying process is not well understood, in nursing school I had the opportunity to sit in on a hospice consult in which the nurse did an excellent job explaining that like birth, dying has it's stages as well. She explained how the body starts to shut down and that naturally energy is transitioned to basic functions such as breathing, keeping the brain alive, and the heart beating. This is why we don't need to eat or drink while we have started the dying process, our digestive system has begun to shut down. It is also important to remember that dying takes energy. Even without a drop of pain medicine or a drop of sedatives while dying we become nonresponsive, this can be the hardest part of death for loved ones as the patient can probably still hear and be aware of what is said and going on around them, but they do not have the energy to open their eyes and answer. So in regard to "snowing" (giving pain/sedative medication to keep the patient "out of it" or asleep) is not a practice of hospice care. All medications are titrated (adjusting the dose up or down/changing the frequency) to keep the patient as comfortable as possible. For those who are unable to verbalize their level of comfort assessing breathing patterns, facial expression, moaning, and restlessness can be the only way to evaluate comfort. It is unethical for any care provider to knowingly administer or hold treatment in attempt to cause death and it is also unethical to hold pain/sedative medications to someone in pain while dying because you believe that if they can't ask for it then they don't need it. In a perfect world all medical providers would balance benefit to the patient with risks/side effects of treatment. Like patients who are not ready to give up receiving treatment at any cost, we also have providers who are not ready to stop treating patients agressively due to personal beliefs and morals (taking death of a patient as a personal failure and stopping treatment as "giving up" or providing treatments to make more money) . Hopefully the latter is never true in any case. Personal beliefs/morals of medical providers resulting in under/over treatment is the reason the lay person now makes decisions regarding medication/treatment/procedural options, end of life care, and whether or not they want someone to attempt to resuscitate them if they are dead. (It is important to know that CPR is provided to those who are not breathing and have no heartbeat ie dead) This is a very blunt statement, however, with all the information available to us it is a concept that those unfamiliar with medicine actually understand. In theory, a perfect way to give control to ourselves or loved ones who will make these decisions for us when we are in a state that prevents us from making the decision ourself, but in practice is not without fault. It is very difficult for someone who is not educated in medicine to know benefit vs risk of any treatment and apply it to themselves or loved ones. Ideally, the individual has already layed out their wishes clearly in an advanced directive or at least enough to guide the providers to what level or agressiveness they would like to be treated with. (the most common being if 2 providers are in agreement of vegetative state, terminal illness, or clinical death ie brain death......). The other is known as a POLST Form (which in this state is green and is to kept with the patient) and copies of the original are acceptable to be provided to hospitals or care providers. This one page form is simple in theory, however the concepts are not fully understood at times. The first section addresses if you are dead (not breathing and without a heartbeat) you either check a box for DNR (do not resuscitate) or you check the box Attempt Resuscitation [CPR:chest compressions- on a human will break ribs(you will hear and feel the ribs break with the first compression-not pleasant if you experienced being the one to provide compression #1) but necesssary to manually pump the heart ie circulation; breaths(in the out of hospital setting this is the breaths you provide ie mouth to mouth and paramedics in the field and staff in the hospital setting place a tube and use a bag/valve mask to provide oxygen and breath for the patient, medications, and if there is an abnormal heart rhythm or electrical activity defibrillation ie shock (yes the shock is painful but necessary to reset the electrical system of the heart so it can pump ie the muscle contratction - very important to remember they are 2 seperate systems that must work together in order for the heart to beat)]. Simple in theory, but remember if you are the lay person and this is your loved one, you typically feel as if you are making the decision for this person to live or die. Not accurate as they are already dead,thus requiring CPR, but feelings are real. The second part of this simple form is referring to someone who is still alive (has a heart beat and is breathing) and has three levels. level 1-comfort care: keep me comfortable while I am dying. level 2: limited interventions such as supplemental oxygen and manual assistance with keeping patent airway ie suctioning secretions from the mouth or throat or more agressive suctioning(known as deep suction) to clear secretions from the trachea) and medications to sustain life. no mechanical ventilation, this level requires a DNI(do not intubate) order and no forms of mechanical ventilaton to be used. (bipap is mechanical ventilation although it is not invasive like intubation and ventilator support) level 3- full treatment which means do everything possible to keep me alive. The next section addresses antibiotics and also has three levels. level 1- no antibiotics. level 2- antibiotics can be used with comfort as the goal of therapy. level 3- full antibiotic treatment. The last section deals with hydration/parenteral nutrition and has three levels as well. level 1- no intravenous fluid hydration and no form of parenteral feeding (perenteral feeding can include intavenous nutrition such as PPN or TPN; or tube feeding using a nasogastric tube or auctual placement of a feeding tube into the stomach.) level 2- use of iv hydration or parenteral feeding on a trial basis only.( unless you comment on a specific length of time or that there must be progression towards improvement, trial period is open to interpretation by providers and yourself/loved ones making the decision of how long or what a trial period entails). level 3- accepts all forms of hyydration/nutrional support. Check the boxes, patient or durable power of attortney or represntative/guardian of patient signs the paper, and then the physician signs the paper. Easy as ABC/123, we would all like to think so. Again because we have decided that the lay person makes the decisions we now have a live person who is terminal, deteriorating, or starting to die and to the lay person it feels as if they are being asked to play god. We haven't even gotten to assisted suicide, legal in only a few states. To this my only comment is: There is no legal way to define quality of life as it is/means something different to each individual. It was recently made legal in our state of Washington, however, to be carried out in practice the criteria is: you must be terminal, you must follow the process to make the request, you have to request the medication to be prescribed by a physician (by the way, no physician is reqired to fill your request if it compromises their beliefs), then you must take your prescription to be filled at the pharmacy (out of hospital or if facility allows individual this option then filled by hospital pharmacy); the law does not require that pharmacies(retail/clinical) participate so no pharmacist is required to fill the prescription of lethal medication if it compromises their beliefs; and now the last part, you must take the lethal dose of medication by self administration. It cannot be given to you(a provider is not able to crush and administer it via a tube or administer it in an iv form). Add the hospital setting, you now have gone through the steps all the way to getting it filled, but medications must be brought to you by the nurse, who is not reqired to participate if it is against their beliefs. As healthcare providers are not required to participate in treatment/procedures that requires them to have an action in the treatment/procedure. For example, a nurse who is Jehovah Witness can refuse to administer blood/blood products to a patient, but if another provider is administering blood/blood products to a patient in their care they are not relieved of the responsibility to monitor the patient. As monitoring a patient in your care does not require you to take the action of administering. Another example, you cannot refuse to care for a patient who is a prisoner or inmate because monitoring and providing medical care does not require your action or participation in the crimes they have or are alledged to commit. Wow, we have really complicated a lot of concepts that seem so simple and so black/white and with government involvement and legislation we have created even more shades of gray. So, do i think we now need medicare and the government to step in and create a new program or require hospice care to expand from comfort care to adding additional treatments, and expand again to include agressive treatment. The answer, NO. If we do that, we are no longer providing hospice care, we are now asking our hospice care facilities to act as an acute medical care unit. If a city/hospital has the ability to provide transitional care or palliative care programs and individuals would like to participate in those programs, then great. Medicare can cover that level of care as they choose. Hospice care should not be changed to expand treatment to those who are not ready to accept the level of care provided. Again, Hospice Care is a level of treatment using comfort measures to keep an individual comfortable during the dying process. Any additional medications/treatments/procedures should be administered in another setting because they require a higher level of care. I also would see it more beneficial to educate providers at all levels to communicate with families when treating terminally ill or those of any age with multiple medical problems who are no longer benefitting from modern medicine because if we as providers cannot tell someone we have exhausted all our options and hospice is the most appropriate level of care. WHYand HOW do you expect the lay person to accept that there are no more options??? We will all have issues with denial, but if the professionals are not capable of communicating we are at the end of the road, it is going to be harder to accept that I am at the end of road. Sorry this is so long, but these issues are not so simple as we all would like to think, and than we want our hospice providers to start acting as medical floors on location and medicare to expand or create new progams to accommodate denial and poor communication. Not a good idea to open that can of worms, look at what a mess medicare/governments/us have already made with what we thought was a simple process or the solution. Education and communication need to improve. To do that we need everyone to have access to a primary physician, best to pick one with beliefs and morals similar to your own, this would be a better use of medicare/medicaid funding then expanding or creating new programs because we have forgotten something as simple as :"do no harm".

Unfortunately I had the opportunity to avail myself of Hospice care twice. The first was with my father who died from lung cancer and the second was my husband who died from colo-rectal cancer. With both of them they had reached the point where further chemo/radiation would do no good as the cancer had advanced and spread. Both times it was my loved ones decision to agree with their oncologists and not receive further aggressive treatment. They both died at home with me being their only caretaker 3 months after entering Hospice care.

Without Hospice they both would have died in a hospital or nursing home alone. Hospice did not kill them the cancer did. I'm thankful that they had the option of remaining at home with the help of Hospice. I have to say that the difference of care from their nurses couldn't have been different. My Dad's Hospice nurse was an angel sent from heaven. She was a patient and caring woman that I adored. The second was a cold bitch that acted like we were a bother to her. I ended up despising her. The care they both received was good, just the delivery was different.

Even though I had two very different experiences with them I am thankful for Hospice and am comforted to know they are here if/when I need them.

After my Mother was in several situations of (very) bad care w/i assisted-living facilities...and one being a VERY well-known respected facility, she was emotionally very affected. I placed her in the hospital for re-evaluation.

With her illness, she was treated with emotional and physical threats in one ALF, where the tables were covered with white cloths in the dining room and the grand piano invited the "guests" into the belief, that every day was a wonderful day. From there, as I moved her, she was placed into a situation where she became emotionally-fetal.

I raced to remove her and get her into a hospital after what she was going through and seeing her rapidly change. Again, a doctor was my "hold-up", whereas w/o the paperwork, it is impossible to move with Medicare quickly.

Once, in the hospital, my Mom's diagnosis changed to her needing a nursing home. I had to switch my cap around and think in another direction. I THOUGHT that the nursing home...a well-known national (church-sponsored) facility offering peas-to-nuts, at a hefty cost (still being non-profit) would have the professionalism finally to help my Mother.

I don't know which is the biggest mistake that we make in life..."trusting" or "thinking".....w/i four months, my Mother was taken "down". Rashes covered her upper torso from the drug that she was given that never should have been administered. She was placed in an inadequate sized wheelchair and left there for hours.

With that said, hospice came in and told me that they would do all sorts of wonderful things for her....send in volunteers to exercise her legs...take her outside for walks...help her in every way possible. They would also offer the services of a case-manager nurse and a doctor.

Since, the facility's contracted doctor was not taking care of my Mother, I welcomed the second offer finally. I was not happy about my Mom having so many more confusing faces in front of her. But, I trusted the "words".

I ended up fighting against these people....I would go in to see my Mother several times a week, eventually leading up to daily visits. What I saw occur to my Mother led me to try getting her into a hospital for better care. The hospice nurse and the facility staff nurse begged for more time...and stopped me at every point of departure.

As my Mother declined in that facility, the only way that I got any doctor to sign for her release to a hospital was when a "weekend" nurse came to me and told me to "get Mom OUT"! She got a new doctor to place an ok on papers...and out Mom went. NEVER to return.

When, I saw my Mother's body in the ER, I had to STIFLE my scream....the doctor and the nurse looked at me...and told me they would make a report. My Mother was covered with an allergic rash...that the hospice nurse had tried to dismiss with me, five weeks earlier as non-existant and only in my MOM's MIND!

How much agony my Mother had to have been in and not had the words to express herself by...I can only get pains in my chest as I sit here and write this w/i days of this passing by one year now.

There was a cover-up between the facility, hospice and the doctors. I put all of the facts down after my own research (and you know, I like to get lengthy)...and spent probably 500 hours last summer doing so. I am now in a bad cycle of being up all night long...and sleeping partially in the daytime.

Bed sores...pressure sores...and the rashes that covered my Mother's body were noted the day she entered the ER. She was being given...antihistamine for a runny nose.....................whereas she had DOUBLE PNEUMONIA!!!! I reported the pus in her eyes to a nurse..giving her meds...that never even bothered to look down at my Mother's face. She would stand over her and hand her the meds around her shoulder..and then walk off.

As I watched her do this in the nursing home one evening, I grabbed her and took her back to my Mother...."don't you see"???? My Mom was "doomed" to die with the attitude that existed in this nursing home that towers in town paying big taxes. No ONE will go against them....EXCEPT NOW ME!!!!

The papers that I compiled along with pictures are now in the hands of well-known attorneys. I hope this case makes a lot of NOISE.....I hope this case makes people realize that we have to be aware...that not eveyone....not every facility....is truly going to be there FOR you!!!!!

When, a admission fee includes every penny that you have in your shoe box or your vault....and the guarantee is that they will be there for you for one day....or one hundred days...or ten years....be very aware of the fact....that once you dig into the "back rooms"...some corporation is investing your admission fee...and counting on a profit.

The care and the neglect of the elderly is a major "tickler point" for me...as I have been so involved most of my life with either caring for relatives....living in neighborhoods with retirees or as with my Mother being involved with her life 100% for many many years.

My background is sales and marketing...and as a rep, I looked at all corners as I walked into a situation...just as I hope to do with all of the aspects of my life and those around me. We can never be complacent..we can never just accept...we have the right to voice our opinion...and make changes. We are still free in this country....although the times are harder to believe in...we still have a chance.

Be aware that there are LOTS of businesses that feed off the elderly as they go through the last part of their lives...those people "count" on lonliness...they feed off of the facts that someone has to make a decision in an emotional time of upheaval. For every person that I have worked with as a volunteer, I have encouraged that they have a "buddy-system"...whether it be a neighbor...a friend..a child...before making a decison, find someone to bounce off of as far as your plans....your ideas.

My Mother was an intelligent woman who owned a business and had an emotional involvement with others. As life proceeded, she felt that her decisons were RIGHT. She never consulted with anyone. I only came along to pick up the pieces in the last part of her life, based on all of the decisions that she made which were not of a clear thinking elderly person as dementia started to work its way with her brain.

She should have spoken w/me before it became too late...to stop the downhill process in her life. At least she had me...sometimes, she realized it....I wish that I could say I will be that lucky....for those that can now look around them and see people that care about them truly...before it is too late...grab those hands and sit and talk. It will be your greatest asset as you age, to have someone care about you....and what happens to you.

To Jeanie 18.... As soon as I discovered what hospice (the only one in the two county area) was doing, I fired them verbally as I rushed to see my Mom admitted to an ER. I was told on the phone by the floor nurse, that the contract would be voided. I said "fine".

In the ER, I rec'd a call from the ins. care manager telling me of an email that she had just rec'd that day from the hospice nurse, which was VERY deragotory towards my Mother and myself. I was sitting beside my Mother in the ER, and listening to a phone call that was making me furious!

When, the ER doctor came in to give me a report...I told her as to why, I wanted my Mother admitted to the hospital...for her rashes..and the bedsores. She told me that the hospice nurse had just called her and told her to return my Mother to the nursing home...NO ONE ever looked at my Mother's body on that date.

I literally raced home to send a letter to all concerned firing hospice before mid-night. As of 8AM the next morning the special mattress for my Mom's body was removed...the special wheelchair was removed...

I have a copy of the email from the hospice nurse to the case manager referencing my "big mouth" and my Mother's supposed-problem with rashes. Please, never believe from such printed words that I sat quietly by and did nothing....the system...does not allow the transfer of human beings..w/o the papers...being right on the line in order.

I spent the next several weeks correcting all of the areas with paperwork for insurance for my Mother that w/i one swoop of a pen..Hospice had erased. I notified the corporate office of Hospice...and never heard one word from them....not one breathe of concern...for what their nurse did to my Mother.

No thank you.................I am beyond ever being able to keep my cool...when it comes to that town..that facility or hospice. I know now all of the inner connections...as I pulled papers and read files. Enough NOW to make me scream. I was not given the reports that hospice had...from the doctor at the nursing home.

As far as hospice and the nursing home were concerned, "NO OUTSIDER" was to have ever seen my Mother's body. She was to have died in the nursing home and been taken directly to the funeral home and then cremated.

I DID see her....even in the hospital a guard was sent up to ask me what I was doing...as I tried to take pictures of my Mother while she was in bed. The hospital told me that they would document...take pictures...and make a report to the state............they did not. There was a major cover-up in that town as to what occured to my Mother...

But, they do not know who they are dealing with...they will eventually........though. I am very thorough....! For all of the crap that my Mom went through, I did make detailed reports to the state.

The state did investigate....one facility was written up significantly...those that are of a better stature in the towns...they only had inspections...and the crimes continue.

I went to the mortuary, on May 14th, the day after my Mother passed away to see her body....THEN, I DID SCREAM! My Mother looked as if she had been beaten with a meat mallet....it is a scene....that I wish I could forget...I know that my youngest daughter being in the room wishes that she had not seen the horrors that she witnessed, as she moved closer when I screamed.

And.............of all people, I WAS very attentive...and supposedly careful about my Mom...I had spent years...doing research on facilities...went to meetings...met with doctors and social workers...and still, I lost....Mom won finally, she is okay where she is now with all those that she missed and loved in life....it is me that has to remember...............and that part I hate!

Suckerfish: I really appreciate your followup, sometimes in order to form the correct impression there needs to be more emotion shared along with the facts. I can see that you and I have recently traveled similar paths unfortunately with different encounters along the way. Being in the health field myself I certainly realize the differences that are within each of us and there are many healthcare workers that do not belong in this field. I really try to weed out those that I hire mistakenly that have no empathy or compassion with their patients and their families. All I ask is please keep looking for those that are in the field because they honestly care about people and want to make things better. Also you are absolutely right in saying that people have to become involved and proactive with their loved ones, this includes standing up for yourself. I tell my patients if you won't fight for yourself how can you expect someone else to? I come from a family of lawyers (which isn't always a good thing) and you're doing the right thing with making them responsible...Good luck...

Wait, how is being able to continue treatment while getting hospice care a "death panel"?

Chris, as you can read, different experiences for many people based on a variety of circumstances. Some families do indeed find solace from dealing with a hospice program and staff. For some families that is a definite need that in some cases is being met.

If, Medicare will allow for a program to encourage a quality of living for the known-to-be dying patient, than there should be a wide growth in compassionate care. Not just a program under hospice that lessens the pain with death and lets the process go faster without delay.

I did not see that for my Mother. I fought against it. I wanted the "best" that could occur for her with the time that she has left, which could have been at least a year or longer. The "feeling" has been expressed...that she did not even get a chance to die from her diagnosis. With the lack of care that she rec'd because of hospice in conjunction with the nursing home where she resided, her death was hastened by 9 months at least...and in a very unnecessarily "sorry way" for her.

Even after she entered the hospital for what turned out to be the last time, she improved so rapidly by just being out of the nursing home. The hospital social worker actually told me to find a new facility for my Mother to move into. Wow, I was so excited about the possibility...that as I visited her one day...she was joking with me...and making the staff alert to the fact that she was trying to get out of bed.

Elder care is BIG business by the mere fact that such a large population is coming-of-age now as to needing assistance with living and with dying. Foreign investors have purchased MANY facilities and tied them into bundles for investments sold on Wall Street. Roto-Rooter is the corporate investor in a hospice agency in Florida.

When a bed turns over quickly, a profit is made. Moving a patient into a facility and charging an admission charge ie long term care/continum care is a big business. So, unless we have someone who cares about us as we age...we are at the mercy of a system that indeed needs to be adjusted and repaired before we are too old to understand what can happen to US. The "fix" needs to be NOW!

(To Jeanie 181...I wish that there were more professionals that did care...in regards to the elderly or the very ill as they age...I see a group in my mental room that lost the heart...for the caretaker that threw a wet diaper at my 40 year old friend with MS that had to go to a nursing home, while she recovered from a stroke....for the aide who shoved the old woman into the shower, after she pulled her clothes off of her..& w/the old woman screaming..For the director, who fed her residents watered down gravy with a few chunks of meat for dinner. My antenna rises and my head twirls around on its axes...just waiting for one more chunk of heartless care to fall upon one more old foggey...that people forget to see as human).

Please do not classify me by a party because you would be wrong first of all. All I know is one thing - Canada has socialized medicine. I've heard so many praise it - mainly the people who are for that type of medicine in this country. I have lots of Canadian friends. One in particular had cancer. Yes, he was not denied medical treatment. He was delayed it. A simple procedure which would have saved him horrible pain was put off because "he was dying anyhow". Yes, he was dying but he still wanted to have every last moment with his family up until it happened. He couldn't have quality time because he was in agony so much. No thanks. I have heard the spiel but am a first hand witness to the Canadians flocking across the border here when they need medical procedures that are delayed too long up there. What is the good of so-called free medical treatment when in too many cases it's delayed treatment?

....and, Choice please, that is the impression that I got from the hospice nurse and her manager as THEY decided what plan of action they would pursue. I was determined from the first moment to watch these people.

When, I gave them a "shopping" list of what my Mother's problems were occuring, I was "hmm and hawed". I was even told by the nurse, to keep my requests "down" as I spoke with the hospice doctor. I was on my guard, as we spoke, knowing that the nurse was right beside him listening to our phone call.

As he was so pleasant, I felt that I could open up to him and telll him about my Mother's "new" problems. From that point onward any contact with him was monitored and limited by the nurse. When, I found out that the plan according to hopisce was NOT to cure with a quality of ending life...but to let it happen with pain meds and solace.

I came in one evening to find my Mother behind curtains crying in bed, as she was isolated. She was looking at the clock on the wall, knowing that she needed to be "somewhere" and that she was feeling hungry. She did not understand that she was not able to get to where she wanted to be...and that place would indeed be where she could eat and be satisfied.

She had been "doped-up" with morphine. In order to remove the bandages from her bedsores every couple of days, instead of every day, she would cry in pain....so she laid in that bed....crying that she was hungry. And.......that is how I saw my Mother one evening...right before I went roaring down the hallway.................In my Mother's case, the nursing home was geared-up to work with the dying...not with those that as they were still alive and dying...to give them a graceful and safeway to leave this earth.

Hospice was NOT a savior for my Mother...they were more of a deterrent, as I wrote earlier. I brought my Mother to the facility because of trust...I left with rage and disgust. I approaced the CEO of the facility as I thought my Mother was on the up-swing before she passed...and told him that it "was all about moving them in and out"....turn over the beds for the most profit. When, corporations are running nursing homes...and assisted-living facilities...and not allowing good care for human beings...we as the next-in-line had better start making fast changes.

I have dealt with these facilities as a vendor..and when you see the management/owners NOT paying the bills for pest-control and cleaning supplies.............you get a precise CLUE! It is all about the money! Not the care........so, sign me bitter and not so sweet...anymore!!!

My read on this is that it will give us more slack for the patient and allow some treatments that may be considered technically "aggressive", but that provide additional comfort to the patient. I don't see it as giving carte blanche to continue all aggressive treatments . . . putting patients on a vent, for example, or continuing chem...otherapies that make the patient sick and less comfortable. The writer is correct that many families balk at signing a loved one up for hospice care until they are actively dying. And we can do so much more for the patient and the family when we can get in there sooner. If treatments like hemodialysis or palliative radiation can ease the suffering of a terminally ill patient, and the patient can tolerate it, then why not? I think that we should welcome ANY tool in our arsenal that will increase the comfort of our patient as long as we can do it. As with any mode of treatment, it will take educating the patients and families about treatments that will promote comfort vs. treatments that are futile and will cause discomfort.

There is a real fine doctor that is avocating for the Public Option. His name is Dr. Michael Rushnak, M.D., and I invite you to visit his Facebook page, ' Healthcare Reform 4 ALL AMERICANS.' He is requesting signature support in getting healthcare professionals speaking to Americans via national media about real healthcare reform.

My Grandpa received hospice care - but he did have to give up and curative treatment in order to receive hospice care. What that did to him is told him he had to suffice to giving up and lost all hope. Once he accepted hospice, his health rapidly declined and he died.

He NEEDED hospice care, there was no doubt! Grandma couldn't care for him herself at home, insurance companies wouldn't pay for home health care (the family paid out of pocket for these nurses before hospice came in). Many elderly lack having people available to them to help them at home and many families are all working full time trying to take care of their families.

What a horrible decision it was for Grandpa and the family to move forward with hospice care - because he had to leave behind all of his hope in order to get the care he desperately needed at home! He needed nursing at home, but this was not allowed due to insurance restrictions. At least this provision in the health care will provide the needed care to patients.