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Joan E. Dowlin

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Hospice Shows How Socialized Medicine Can Work

Posted: 03/30/2012 6:04 pm

My dad recently died of lung cancer at home. He was 91 and I was his primary caretaker. I don't think I could have handled his end of life process without hospice care. Even though other family members (my sister and cousin and brother with his wife and sons) and friends were there for him and me, it would have been an impossible task without hospice.

Hospice brought the comfort of knowing my dad would have a hospital bed, oxygen, medication including morphine, a daily aide who bathed him in bed and changed his sheets, and a twice a week visit by a nurse who was on-call at all times.

They provided a social worker and chaplain to not only console him but we caretakers as well. In essence, they were a Godsend to a family in need. These angels reaffirmed my faith in the human race.

And the beauty of it all is that it was paid for by my dad's Medicare. That took a huge financial burden off of the family and allowed us to focus on making his last days comfortable.

As the health care debate again rages in D.C. with the Supreme Court taking on Obamacare, I can't help but wonder if these same folks that scream about keeping the government out of medicine would refuse hospice care for any of their family members.

This is not my first experience of hospice. My mom passed in 2006 of Alzheimer's disease and she was under hospice care for two years. This was a great support for my father who was her primary caregiver. My sister died in 2007 of breast cancer and she and her partner benefited greatly from the nurturing experience of hospice.

I don't know if it is because a certain quality of professional nurses, aides, social workers, and chaplains are drawn to the field, but my observation has been that these people create a compassionate and empathetic environment that eases the pain of losing a loved one.

If only all of our health care system could work this way. If we used such a caring, empathetic, comforting approach to all patients no matter if they were dying or not and if we brought such passion to preventive medicine maybe we could find a system that works for all. No matter what happens to Obamacare, I hope we recognize the benefits that hospice has created through Medicare and I for one will be eternally grateful for that precious support and care at a time of great need.

 
 
 
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02:56 PM on 04/16/2012
What a silly headline!

Hospice is a palliative medicine delivery system. And the posters are correct, the folks who administer hospice care, are truly angels. it is, however, ignorant to use hospice care benefits as an example to buttress one's political leanings. It is available for private payers, as an insurance benefit from virtually all private insurance and, like hospitals, prescriptions, walkers and many, many other items, is paid as a medicare benefit. Who pays for hospice has nothing to do with hospice, in fact, in our capitalist society, even virtually all for-profit hospice will accept patients without regard to their ability to pay, as many folks donate to hospice.

Hospice care is humane and effective irrespective of the economic system of government in the jurisdiction of delivery.

Period.

The fact that the significant majority of beneficiaries of the system are Medicare-eligible is besides the point. A 22 year old Aids patient will appreciate this. The true discussion point here should center around the end of life conversation, and the efficacy of expensive, invasive procedures on those facing incurable illness.
08:10 AM on 04/10/2012
Sorry for your loss Joan.
Living in Canada, I am grateful to have socialized medicine to help me care for my aging parents. I wholeheartedly agree that hospice and palliative health care teams should be held up as the model for all health care.

PS: I, too, am a professional horn player, but I put down the "ax" a few years ago.
02:08 PM on 03/31/2012
My mom died in the nursing home she'd lived in for seven years, with Hospice there to make sure she had all the morphine and comfort measures she needed. Many of the things Hospice offers for people who're dying at home, such as hospital beds and other equipment, plus aides to bathe them, weren't needed in the nursing home. But we were grateful for the comfort measures and for the fact that the Hospice nurse could pick up the phone and immediately order any other meds she needed.

When my mom died, all of her family was around her, and the Hospice chaplain was a great comfort to her and to the believers in my family. It was as positive an experience as something like that could possibly be, and it was a real bonding experience for our family. Although Mother wasn't very alert, she knew that her sons and daughter and daughters-in-law were all there together, enjoying one another's company and support, and I know she couldn't have asked for anything more.
02:08 PM on 03/31/2012
One other beautiful part of the experience, non-Hospice related, was that I stayed with my mom's body until the funeral home got there to pick her up, and I waited while they bagged the body and wheeled her out to the hearse. But the beautiful part was that, as her body was wheeled out, the nursing home staff formed two lines at either side of the door and sang "Amazing Grace" the whole time we were passing by. It makes me cry to think about it.

It was such a beautiful experience that at the funeral, as the coffin was wheeled out after the service, we asked the mourners to stand and sing "Amazing Grace" as she was wheeled down the aisle.
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Joan E. Dowlin
Love will find a way.
04:47 PM on 03/31/2012
Thanks for sharing that beautiful story. Makes me want to cry too.
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Belle Starr
cattle rustler and horse thief
10:53 AM on 03/31/2012
I took care of my parents during the last years of their lives, and hospice was there the last few months. They helped me to realize their wishes of passing at home without being hooked up to machines. They were a Godsend.

The only thing I found a little weird was the chaplain''s response to my filling my Mother's bed with stuffed animals and toys. She asked why I did that and I told her that Mom said children had been visiting a lot so I made sure that there were toys for all of them to play with. The chaplain was aghast asking me if that went against my religious beliefs so I told her that I was an atheist and if the toys made my Mother and her little friends happy, it wasn't anyone's business. We never asked for a chaplain and I'm not sure why she showed up, but she was fine after that.
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Joan E. Dowlin
Love will find a way.
05:43 PM on 03/31/2012
I think that is sweet that your mom wanted stuffed animals in her bed. When my mom had Alzheimers she went through a period where she kind of transgressed to her childhood and liked to hold a stuffed animal or doll. I think it was comforting for her. The chaplain had no right to judge you or her for that. My dad told the chaplain "religion is for dummys." Here is an article I wrote about him: http://www.huffingtonpost.com/joan-e-dowlin/im-not-worried-about-his-_b_1257733.html Thanks for sharing.
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Belle Starr
cattle rustler and horse thief
06:35 PM on 03/31/2012
Dear Joan,

What a lovely tribute to your father and mother. My mother also had Alzheimer's and my Dad was blind from a WWII combat injury in North Africa. Other than my father being a devout Catholic, he sounds very much like your father. My best to you
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minerva117
The dog ate my micro bio.
10:37 AM on 03/31/2012
I worked in a nursing home for 9 years and i saw firsthand what a blessing these wonderful people are.
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walkinthedogdude
If you can't be on-time, be early
11:53 PM on 03/30/2012
My wife passed on at a hospice more than 7 years ago. I have a word I think best describes the persons who worked there: angels.
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BOBinPS
Really?
07:28 PM on 03/30/2012
I totally agree with you. But in order for hospice to work, the patient has to agree to go. After 96 years of a healthy and independent life, my mother suddenly developed severe anemia. Testing showed no evidence of a bleed. She agreed to extensive imaging, a colonoscopy, and surgery to remove a small colon tumor. She died three agonizing weeks later of complications of anesthesia. Being of sound mind, she agreed to these procedures despite my council. She ultimately died after being in hospice for 22 hours. The problem with health care - socialized or not - is the failure of end of life counseling. She suffered for 3 weeks because she was offered extensive and expensive procedures without fully understanding their risks and being given unrealistic hope of regaining her prior lifestyle. If her decisions came with financial risks to her trust, she might have made different decisions. But, who knows for sure.......
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Joan E. Dowlin
Love will find a way.
02:00 AM on 03/31/2012
Sorry to hear about your mother's experience. My dad at 91 decided not to get any treatment for his lung cancer as he realized the cure may be worse than the disease. He probably knew instinctively that he wouldn't survive the chemo and radiation so he got to live out his days being as comfortable as possible. I am not big on drugs as was he, but I have to say thank God for the morphine. This was a case were it was necessary and helpful. And thank God for hospice too.
02:15 PM on 03/31/2012
When my mom was hospitalized with congestive heart failure and kidney failure at age 95, she saw her doctor's offices "hospitalist," who's the doctor patients see instead of their regular physician. We'd never seen this doctor before and he'd never seen my mom. We tried talking to him about her prospects, but he was unforthcoming, and kept encouraging us to think she could recover from this and go back to the nursing home.

It was only when that doctor went on vacation that we got a different doctor who very gently suggested that Mother should be on Hospice. That was the information we'd needed and tried to get from the first doctor.

I'm afraid too many doctors either are uncomfortable talking to patients or theiri families about the prospects for recovery or regaining any quality of life, and some simply refuse to discuss it even when asked. Others, I think, are so accustomed to thinking their job is to save lives and never give up that even when the patients and family members, with proper information, would choose to allow the patient to go quietly and in comfort, these doctors continue to push treatmens that, as you say, are costly and unrealistic and in the end do more harm than good.

My familiy believes in 'pulling the plug," as we say. Yet even we couldn't manage to communicate to this one doctor my mother's wishes, or ours.