The Dirty Business of Dying: From Charitable Endeavor to Cut-Throat Enterprise, Hospice in America is a Shameful Shadow of its Former Self.
I ’m learning there comes a time in life – providing you are both willing and able – where you review where you’ve come. You take stock of where you’ve been. Have you made the world a better place or just endured existence from the cheap seats?
As a nurse who has committed a life’s work to easing the suffering of others, I applaud breakthroughs
that have become best practices: the World Health Organization ladder of pain control; use of the pain assessment in advanced dementia in non-verbal dementia patients; advanced certification in hospice and palliative care; a myriad of ways to deliver comforting concoctions and so much more. However, the deepest and richest treasure in the clinician’s toolbox remains the Medicare Hospice Benefit.
Had you been terminally ill before the mid-1980s, you might have received care in your home from well-intentioned volunteers or nurses who were paid for their services through philanthropic means . But that changed in 1983 with the designation of the Federal Medicare Hospice Benefit. ‘The Benefit’ now provided Medicare beneficiaries with courage for high-quality end-of-life care by accredited agencies.
The United States borrowed the recipe for hospice from Europe, where the care
began in the mid-1800s with terminally ill being cared for compassionately in homes by well-intentioned volunteers. The cornerstone of hospice is use of an interdisciplinary team, where each member addresses an aspect of care.
Palliat Med Hosp Care Open J. 2020; 6(1): 5-6. doi: 10.17140/PMHCOJ-6-134
