A recent article in The Boston Globe's business section highlights the challenge hospice providers have in "selling" their services to patients.
The idea behind hospice care is to provide comfort care and counseling to both patients and their families when patients are deemed to be within six months of passing away. But the association with death and giving up makes this a hard choice for patients and their families, as well as the hospitals and physicians who might recommend this type of care.
Ironically, in some cases the palliative care is actually the best care for prolonging life. In one study published in the New England Journal of Medicine and reported in the Globe article, advanced lung patients receiving hospice care in fact lived three months longer than similar patients receiving aggressive treatment. Treatment not only affects the quality of life, but can have its own detrimental side effects.
While hospice care focuses on the comfort of the patient and permitting both the patient and family members time to come to terms with the coming death, unfortunately, many patients are referred to hospice programs only in their last few days of life when further medical treatment is deemed futile. This can limit the benefit of hospice care to the patients and their relatives.
Hospice care is covered by Medicare and most insurance policies and may be provided at home, in assisted living facilities or nursing homes, or in specialized hospice centers. It is less expensive than hospital treatment, which contributes to the high cost of medical care in the United States. In 2008, Medicare spent $55 billion on treatment during the last two months of beneficiaries' lives, more thant the federal Homeland Security or Department of Education budgets. (Click here to read an article on end-of-life medical costs.)
Ironically, according to the Globe article, these very costs may be part of the reluctance of medical providers to make hospice referrals. Hospitals make money treating patients, not by referring them out to hospice.
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