“Hospice” is an end-of-life treatment program that is paid for by Medicare. More than one million people used the program in 2008, at the cost of $11.2 billion. However, it is not always known that hospice provides only “palliative” or “comfort” care, and not curative care. Hospice is available to anyone with a prognosis of six months or less to live. Once it is accepted, it is often seen as the last step prior to dying and is used as a preparation for end-of-life. “Curative” care, or treatments aimed at improving the patient’s condition are abandoned. It is that fact makes the decision to enter hospice difficult for the elderly and their families. Diane Meier, director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine in New York City said: “Having personally had to explain what’s good about hospice to families that think I’m about to shove them onto an iceberg, I know it’s a very difficult decision.”
Moreover, some groups have argued that hospice is sometimes abused as a part of the dying process. One group, the Hospice Patients Alliance argues that some patients are deprived of fluids or nutrition before they are at the very end, resulting in life ending from dehydration or malnutrition rather than a terminal illness.
A part of the new health care law signed by President Obama on March 21st, 2010 may help to change the way hospice operates. It introduces a new concept of “concurrent” care wherein both comfort and curative care would be provided by hospice. The law orders such care to be provided to terminally ill children immediately. At the same time, several pilot projects are to be set up around the country to test the concept. If successful, Medicare will provide the dual hospice program to everyone. Whether the program is ultimately adopted on a wide scale depends on whether the approach increases costs or not. Time will tell what the outcome will be and, in the end, hospice may no longer mean halting treatment.
If the hospice change is introduced it promises to be popular with patients. For example, Mr. Jay Chestnut, a seventy year-old AIDS patient, went into hospice in 2004 where he expected to die. However, he was given an experimental drug that stopped his dying process (contrary to the normal hospice approach). He is now continuing his life in Philadelphia, and states that persons in hospice do have hopes of getting better and should be given the chance of a cure no matter how bad the situation.
We at Heritage Elder Law will continue to monitor the trends in the health care industry and especially as they pertain to senior citizens. As new laws are introduced, we will provide this information to better help us serve that segment of our society that is now growing at the fastest rate. Working together we can insure that seniors and those who serve them are educated in the most recent developments in the law.
