hospice

Can Reimagined Hospice Combine Medical Care With Support In Dying?

After a half-century as a Medicare benefit, hospice care still has had only limited success in improving the quality of patients’ lives as they approach their deaths. While more people are enrolling in hospice (about 1.7 million in 2020), they often do so only days before dying. Thus, they fail to benefit from the best of what hospice has to [...]

By |2023-10-23T15:51:01-04:00October 23rd, 2023|End of life|0 Comments

Medicare Must Keep A Closer Eye On Hospices And Nursing Homes That Put Patients At Risk

Three reports in the past month have outlined serious problems with the way some nursing homes and hospices are caring for their patients.  The tales are similar: A relative handful of providers are delivering poor, even dangerous, care that is being hidden from consumers. But the real story is far more troubling:  Neither the federal government nor many states have [...]

By |2019-07-12T13:40:00-04:00July 12th, 2019|nursing homes|0 Comments

Where Do Older Americans Die?

Increasingly, older Americans are likely to die at home, and not in a hospital. And more seniors are using hospice care as they near end of life. However, stubbornly large numbers of Medicare beneficiaries still land in intensive care units or find themselves shuttled from home to hospital and back again in their last months of life. A fascinating and [...]

By |2018-07-01T09:02:56-04:00July 1st, 2018|End of life|0 Comments

Doctors Die Like The Rest of Us

In recent years, it has become conventional wisdom that physicians avoid the end-of-life mistakes that many of the rest of us make.  The story: They die at home rather than in hospital intensive care units. And they rely on comfort care such as hospice or palliative care rather than often-futile high tech medicine. That conventional wisdom, it turns out, is [...]

By |2016-07-20T09:48:51-04:00July 20th, 2016|End of life, Health Care|0 Comments

A New Vision For Medicare: Breaking Down Barriers Between Medical Treatment And Personal Care

Since July 1 was the 50th anniversary of Medicare first enrolling (and paying benefits for) seniors, it’s a good time to think about modernizing the half-century old program. A couple of weeks ago I tried to make the case for why we should improve Medicare. Now, let’s think about how. Medicare needs to better serve a population of older adults [...]

By |2016-07-13T11:49:39-04:00July 13th, 2016|Medicare|1 Comment

Don’t Get Trapped By The Myth Of The “Good Death”

Dying is trendy. I got an email the other morning about “celebrity deaths.”  After the recent demise of David Bowie, Glenn Frey, and “Grizzly Adams,” it seems that everyone is doing it—dying, that is. Apparently, people have been live tweeting the deaths of loved ones at least since 2013. Rock star docs such as Atul Gawande have created their own [...]

By |2016-01-22T10:03:15-05:00January 22nd, 2016|End of life|0 Comments

A New Way To Get Hospice Services Without Giving Up Aggressive Treatment

A new Medicare pilot program will make it easier for patients to access some hospice benefits without giving up standard medical treatment for a terminal disease. It is an important step towards building a health system that fully integrates social, spiritual, and palliative care such as pain management with health care. But it doesn’t get all the way there. Today, [...]

By |2015-07-21T17:46:44-04:00July 21st, 2015|End of life|0 Comments

Hospice Is Becoming a Chain Business

Large multi-agency, multi-state hospices are fast become the primary source of end-of-life care in the U.S. According to a new study, chains cared for nearly half of all hospice patients in 2011, a dramatic increase from a decade before when small organizations (mostly non-profits) provided three-quarters of all care. And my own review of their financial reports suggests the biggest chains [...]

By |2015-01-14T18:06:48-05:00January 14th, 2015|End of life|3 Comments

Reimagining End Of Life Care

Imagine being able to receive fully integrated medical, social, and spiritual care in your own home. Nursing care is available 24/7. Home health aides provide basic personal assistance. Care is person-centered and focused on the specific needs of each patient. And for people with incurable chronic conditions, it focuses on managing symptoms, including pain, thus vastly improving their quality of [...]

By |2014-09-17T15:39:21-04:00September 17th, 2014|End of life|1 Comment

What’s Behind the Criticism of Hospice? Is It Fair?

Hospice is facing unprecedented public criticism. In recent months, The Washington Post has published at least four highly critical articles, alleging widespread instances of poor care and fraud. In June, The Huffington Post published a long investigative piece largely targeting the practices of the for-profit hospice operator  Vitas Healthcare Corp. What’s this about? How did a movement aimed at comforting the [...]

By |2014-09-11T17:37:44-04:00September 11th, 2014|End of life|8 Comments