Posts Tagged ‘caretaking
Is Profit Seeking Trumping Care? Nonprofit vs. For Profit Hospice
The truth is, most people don’t think about hospice at all until it becomes a necessity. The concept of hospice is relatively new in the United States. However, as the number of hospice providers grows, with varying degrees of quality, it’s important to be informed. Hospice places its emphasis on quality of life with care that’s tailored to the unique needs of each individual and their support network. When curative treatments cease to help, the relief of palliative care can bring a new form of hope for terminally ill patients and their families, as hospice services help them make the most of their time together. In 2007, research published in the Journal of Pain and Symptom Management reported that hospice patients lived an average 29 days longer than similar patients who did not have hospice care.
When it came to the United States from England in the 1970s, the hospice movement began as a grass-roots campaign to address the unmet needs of patients with terminal illnesses. The benefits of this care were quickly recognized by the medical establishment. In a 1978 report, a U.S. Department of Health, Education, and Welfare task force noted both the altruistic and practical advantages of government support for hospice care: “The hospice movement as a concept for the care of the terminally ill and their families is a viable concept and one which holds out a means of providing more humane care for Americans dying of terminal illness while possibly reducing costs. As such, it is the proper subject of federal support.” In 1982, Congress included a provision to create a Medicare hospice benefit in the Tax Equity and Fiscal Responsibility Act.
With hospice services covered by Medicare, what started as a purely charitable movement became a probable source of revenue. As a result, the number of for-profit agencies entering into the business of hospice has grown exponentially, with
alarming results. An article published by the Washington Post on May 3, 2014 entitled “Terminal neglect: How some hospices treat dying patients” reported that the quality of care provided by 
hospices varies widely. A Washington Post investigation analyzed Medicare billing records for over 2,500 hospices, obtained an internal Medicare tally of nursing care in patients near death and reviewed complaint records at hundreds of hospices. At many hospices, they discovered that little care was provided for patients most in need. The investigation ascribed this absence of care to skimping on nurses, and to the failure of these hospices to have access to a facility where continuous crisis care could be provided. The investigation found that about 18 percent of U.S. hospices did not provide a single day of crisis care.
The investigation noted that the absence of crisis care at those hospices stands in stark contrast to most others, where such care is common. Medicare payment rates and their unintended financial incentives may be responsible. Providing routine care such as semiweekly nursing visits can be very lucrative. However, symptom management that requires continuous nursing care or inpatient care can be financially draining and logistically problematic, especially for smaller agencies.
An area of great concern is the burgeoning growth of home health care businesses that offer hospice. “For-profit home care agencies are bleeding Medicare; they raise costs by $3.3 billion each year and lower the quality of care for frail seniors,” said Dr. Steffie Woolhandler, professor of public health at CUNY’s Hunter College, lecturer at Harvard Medical School. “Letting for-profit companies into Medicare was a huge mistake that Congress needs to correct.”
William Cabin, assistant professor of social work at Temple University and lead author of a nationwide study published in the August 2014 issue of the journal Health Affairs said, “While our study is the first to show that profit-making has trumped patient care in Medicare’s home health program, that’s no surprise. A large body of research on hospitals, nursing homes, dialysis facilities, and HMOs has shown that for-profits deliver inferior care at inflated prices.”
Researchers believe that most hospices are providing quality care and many nurses in the field consider palliative medicine as much a calling as a job. When the hospice movement took root in the United States, hospice practitioners were typically part of religious groups, or were community-supported like the Texas Medical Center’s Houston Hospice. However, since for-profit businesses have come to dominate the industry, early planning and investigation of hospice care options is a necessity.
Karla Goolsby
Celebrating Valentine’s Day as a Caretaker
Valentine’s Day is a holiday that people love to love or love to hate. Some people love the idea of having a whole day to celebrate their love for their friends, family, and that special someone. Other people believe Valentine’s Day is a made up holiday to generate card, chocolate and flower sales. Whatever your opinion is, as a caretaker acknowledging Valentine’s Day can benefit your loved one.
If you take away all of the commercialization of Valentine’s Day what is left? The answer is simple- love. Dedicating a whole day of love for the people in your life is a great way to realize how valuable they are. As a caretaker, you are already a laborer of love. Balancing work and family is stressful enough. You choose to become a primary caretaker because of your deep love for your family member or friend.
This Valentine’s Day, take some time to think about the love you have for the friend or family member you are taking care of. In the chaos of trying to create a successful balancing act, it’s easy to forget why you are a caretaker. Think about great memories shared between the two of you and talk about them with your sick loved one. You don’t have to buy flowers, chocolates, or cards to celebrate your love for each other.
Also, don’t forget to celebrate the love you have for yourself. Take a moment to think about your characteristics that make you unique and special. When you love yourself you can love others even more. Don’t let yourself forget your worth or that you are a strong, caring person. Give yourself a giant hug and compliment.
Even though Valentine’s Day can seem a little over the top and excessive, don’t forget the message of love. Let others in your life know that you love them even if it’s a simple phone call or letter. And celebrate the love you have for yourself.
World Alzheimer’s Month
This month is World Alzheimer’s Month and the 21 specifically is World Alzheimer’s Day. Over 5 million people in the United Statesare currently living with Alzheimer’s disease and Dementia. As awareness is recognized this month for patients with the disease, those giving hospice care to patients should be saluted as well.
For each person that is living with Alzheimer’s or Dementia, there is likely to be multiple others working with that person in an effort to provide the total care that is necessary to fight the disease. Alzheimer’s patients often need great care from a hospice or caregiver, especially in the latter stages of the disease as Dementia start to have a greater affect.
Even though the month is winding down in the next week or so, there are still plenty of ways you can recognize and increase awareness of the disease. You can have a great impact by wearing purple a few times this month to spread the message of Alzheimer’s awareness. Also, supporters can have an impact on Facebook by changing their profile pictures to the End Alz icon created by the Alzheimer’s Association.
This year, supporters are trying to spread awareness of the different effects of dementia. The fact that Alzheimer’s can affect anyone of any race, both men and women of any status or background makes it a disease that people should be highly aware of. Alzheimer’s is a disease that can transform an elderly person who seems independent into a patient who is completely dependent on care giving for their daily activities.
Locally, this is where the impact of a hospice can come in. In Houston, there are not only Alzheimer’s patients in need of a care giver, but also patients suffering from multiple other diseases. For many of the elderly living independently, their lives could change overnight. With the help of respite care, the elderly will be given the proper amount of diligence and care in a Houston apartment or home. They are cared for by a team of doctors, nurses, aides, social workers, therapists, a chaplain and volunteers.
As the month of September draws to a close, we should aim to increase the awareness of this impactful disease by spreading knowledge throughout World Alzheimer’s Month. The effort in these months of awareness has a great impact by informing thousands throughout the world about the importance of hospice and respite care.
This article was written by guest blogger Paige Taylor, a recent graduate from the University of Texas El Paso.