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While there are many wonderful hospices and hospice staff professionals all over our nation, we wish the public to be aware of new developments relating to hospice and that there are some problems within the industry. Because of the problems in the hospice industry, many organizations including our own are working diligently to help correct these problems. The following articles discuss developments or news of interest to those concerned about hospice care and the terminally ill.
Talks Delayed as Hospice Applies to be Licensed as Funeral Services Provider"
Odyssey Healthcare to Pay U.S. $12.9 Million to Resolve Hospice Fraud Case"
Odyssey HealthCare, a national hospice provider, has paid the United States $12.9 million to settle allegations that the company submitted false claims to Medicare.
Grief fades within 6 months for many widows"
Reuters; March, 2006: "The sad image of a grieving widow may not be entirely accurate, according to a study published on Tuesday showing that six months after the death of their partner, nearly half of older people had few symptoms of grief."
Managed Death: Hospice's 'Civil War'"
By Susan Brinkmann, CS&T Correspondent, March 2005: " The American hospice industry also differs from its British parent in that it's founder, Florence Wald, M.S.N., is an open advocate of euthanasia."
New Clinical Practice Guidelines for Quality Palliative Care Released
Central Texas unprepared for elderly boom, experts say
Finally (or Not), Relief Palliative Care Aims to Soothe the Sickest,
Scandals Continue to Plague Hospice of the FL Suncoast!
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Class Action Lawsuit Filed Against Hospice:
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Hospice Horrors"
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The "Hidden"Annual Costs of Grief in America's Workplace"
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Last Acts releases state by state report (Means to a Better End) on End-of-Life Care"
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Finding Our Way: Living with Dying in America - The Online Course
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Assisted Suicide No Act of Compassion"
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License to kill - Hospitals reserve the right to pull your plug"
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Ashcroft to Pursue Suicide Doctors" [11/01/01- McKnight's Long Term Care News] If physicians in California want to renew their medical license, they must take continuing education classes in end-of-life care and pain management .... " Dying as she lived, with Grace Hospice co-founder led rich life helping the terminally ill" [by Jim Sheeler, Special to the Denver Post, 10/21/01] Carolyn Jaffe, hospice nurse for decades recently passed away. Co-founder of Hospice of Metro Denver, Jaffe exemplified the very best in hospice care! See this article for an example of the real hospice mission. American Psychological Association Puts Out Fact Sheet on End of Life: "What Are Older Adults' Mental Health Needs Near the End of Life?" [8//01]. " End-Of-Life Cancer Care Faulted in Report" (Reuters, 6/19/01) - "The medical establishment, fixated on finding a cure for cancer but largely inattentive to the agony of patients, must devote more resources toward improving the quality of life of Americans given a death sentence by cancer, ....The National Cancer Policy Board of the Institute of Medicine and National Research Council issued a series of recommendations in a report focusing on palliative care... At least half of cancer patients suffer major physical and psychological symptoms -- such as severe pain, labored breathing, nausea, sleep disturbances and depression -- during the course of their disease, the report said. These symptoms ``vastly diminish the quality of those lives,'' the report said. The failure of doctors and nurses to control the raw pain that accompanies many cancers and treatment methods is a source of great anguish to patients and their families, said Dr. Joanne Hilden, a pediatric cancer specialist at the Cleveland Clinic Foundation who served as a consultant on the report." [Note: A need for more research and funding for palliative care and hospice services was emphasized - HPA] " National Hospice and Palliative Care Organization Releases New Pediatric Hospice Resource" Compendium of Pediatric Palliative Care - published 2001. A comprehensive reference on pediatric palliative care, divided into four sections covering: Models of Pediatric Palliative Care; defining the need for palliative care, models of care delivery, program implementation, and models for education; Communication, ethics and decision-making; Management of pain and other symptoms in children; provision of hospice and palliative care to newborns; Psychosocial and spiritaul care of children living with life-threatening conditions; including spiritual and bereavement issues. The Compendium also includes an extensive appendix on materials to assist hospices and others in creating pediatric palliative services. " Focus On End-of-Life-Issues " From the National Institute of Nursing Research (part of NIH): "Families report that dying relatives in the last week of life have much more pain and other physical distress, e.g., nausea, shortness of breath, than physicians and nurses think they have," .... explains the need for quality hospice care as the ideal alternative to routine hospital or nursing home care. " Blacks More Sensitive to Pain Than Whites" WASHINGTON (Reuters - 3/22/01) - Blacks report greater sensitivity to pain than whites, researchers said on Thursday, a finding that may suggest why previous studies have shown that blacks tend to receive inadequate treatment for pain. [Note from HPA: All physicians and nurses are trained to respect the patient's own report of pain as one of the main indicators of whether or not a person is experiencing pain. If pain is not tolerated as well by blacks, then hospice professionals need to be especially attentive to the reports from black patients concerning pain issues. Some nurses or physicians may be providing inadequate pain relief, if this report is confirmed by further research, because they may be unaware of the increased perception of pain in blacks.] " Speaking the Language of Pain" A very important initiative to reduce pain in the dying by the Missoula Demonstration Project (MDP) has been reviewed by D. M. Mayer, MS, RN,CS; L. Torma, MSN, RN, CS; I. Byock, MD; K. Norris, PhD [American Journal of Nursing, 2/2001, Vol. 101 No. 2, P.44] In 1997, with a three-year grant from the Mayday Fund (dedicated to the "reduction of the physical and psychological toll of pain and its consequences"), the MDP launched a community-wide initiative to establish pain as the fifth vital sign, with the goal of improving the assessment and treatment of pain in Missoula. This initiative, dubbed “Pain as the Fifth Vital Sign,” was modeled on the successful work of earlier projects, such as the Wisconsin Cancer Pain Initiative, which sought to improve management of cancer pain in the state’s medical institutions." Yet it was the community aspect of the MDP plan—to educate providers and the public about the importance of pain assessment—that set it apart: its focus encompassed both clinical and nonclinical settings." " Hungarian Police Arrest Nurse in Euthanasia Case" Saturday, February 17, 2001; BUDAPEST (Reuters) - A Hungarian nurse suspected of performing euthanasia on more than 30 terminally ill patients was formally arrested on Saturday in the first such case known in Hungary, Hungarian television reported. " Kaiser Hospice Under Threat Of Losing Medicare Funding" by Janet Wells, Chronicle Staff Writer, Saturday, June 10, 2000 Plagued by patient records that one nurse called 'deplorable,' Kaiser Oakland's home hospice program was under threat of losing the Medicare funding crucial to providing services to hundreds of terminally ill patients. [Note: they must have put in a plan of correction that the State of California accepted, allowing this HMO hospice to continue to function] " Prominent Hospice Doctor Supports Pain Relief Promotion Act" Pain relief should be nonpartisan By Eric Chevlen, M.D. Expert in Hospice Care believes that federal government may be acting to create license to kill in hospice situations ... " Death Without Dignity & Terminal Sedation" originally posted at: Death Without Dignity" and (cont.) Terminal Sedation (Salon.com April 19, 2000) article presents a striking account of how eager doctors are to learn about sedating patients into a medically-induced coma .... JCAHO Releases New Standards for Pain Control http://washingtonpost.com/wp-dyn/articles/A29643-2001Jan7.html An article entitled "New Medical Standard Brings Pain Into Focus" by Susan Okie, Washington Post Staff Writer on Monday, January 8, 2001 ; Page A03 These new standards are a wonderful step forward in the management of pain throughout all JCAHO accredited health care facilities (which includes about 80% of hospitals). The standards encourage careful measurement and treatment of pain. Pain control is being seen as a patient's right, according to JCAHO spokesmen. Dutch Approve Euthanasia Law on Tuesday Nov. 28, 2000 Dutch Parliament openly gives approval to practice of euthanasia which has widely been performed in Netherlands, but was not legal till now. Euthanasia movement gains ground. Doctors "help kill one in 10 Belgians" The BBC of England reports that thousands of patients are killed without their consent, and much more. Friday, 24 November, 2000 "The painful truth of hospice care" and Family sues hospice over son's suffering HPA comments on email protest from hospice executive director Prominent Oregon Physician responds to Hospice Industry "Responsible hospice organizations should welcome the clear light the USA Today articles shed on a serious problem. Any conscientious medical organization wants to recognize problems and correct them, not hush them up." - N Gregory Hamilton, MDInternational Anti-Euthanasia Task Force Details practice of killing patients in Netherlands and elsewhere (covered up by term "euthanasia") In a well-documented article by Rita L. Marker and Wesley J. Smith, a clear picture emerges of a trend toward killing off the infirm, chronically ill or somehow undesired people. Sounds unbelievable? We know it's true, because we receive similar reports consistently from all over the U.S.A. "When did we decide to execute our old and frail?" from the Daily Express newspaper, United Kingdom/Great Britain, Dec. 7, 1999 Investigators are looking into 60 cases (yes, that's sixty cases) of involuntary euthanasia/murders of the elderly and frail in the United Kingdom. When you place your loved one in the hospital or hospice, you may not see them again, or for long, according to this report. And we at Hospice Patients Alliance know that the same thing is happening here in the United States. We receive numerous reports of these types of euthanasias occurring against the will of the patient and family. Survival in End-Stage Dementia Following Acute Illness from the Journal of the American Medical Association JAMA - Vol. 284 No. 1, July 5, 2000. Author Affiliations: Hertzberg Palliative Care Institute, Department of Geriatrics and Adult Development (Dr Morrison), and Department of Medicine (Dr Siu), Mount Sinai School of Medicine, New York, NY. Patients who have Alzheimer's disease or other forms of dementia are often not given appropriate hospice care to ease pain and suffering and would benefit from increased attention to their comfort needs When Will Prosecutors Act? Facts Show Thousands of Terminally Ill May be Murdered Psychiatrist Robert Weitzel was convicted in Farmington, Utah on July 11, 2000 of causing the death of five patients by giving overdoses of morphine. Research reported in the Journal of the American Medical Association shows other physicians have also killed their patients. The Dying Process Can be Eased for Cancer Patients and Families from Oncology.com and written by Heather Lindsey dated May 26, 2000. Hospice services and good pain management can result in a positive experience for the dying and their families. Alternative Designation to DNR promotes better End of Life Care by "Allowing Natural Death" New designation: "A.N.D." would promote positive view of allowing natural death, avoid confusion resulting from interpretations of "DNR" designation, and promote "comfort care only" for the terminally ill who choose to be allowed a natural death. Summary of article: The practice of euthanasia and physician-assisted suicide in the United States. For complete article see JAMA 1998 Aug 12;280(6):507-13 entitled "The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians." written by Emanuel EJ, Daniels ER, Fairclough DL, Clarridge BR done at the Center for Outcomes and Policy Research, Division of Cancer Epidemiology and Control, Dana-Farber Cancer Institute, Boston, Mass 02115, USA.] Attitudes and Practices Concerning the End of Life A Comparison Between Physicians From the United States and From the Netherlands An article in the Archives of Internal Medicine, Vol. 160 No. 1, January 10, 2000 (by Dick L. Willems, MD, PhD; Elisabeth R. Daniels; Gerrit van der Wal, PhD; Paul J. van der Maas, PhD; Ezekiel J. Emanuel, PhD) reports the varying percentages of physicians in Oregon who were willing to increase the dosage of morphine given under various patient circumstances, including giving morphine for simply feeling that life was meaningless or for debility, in addition to the medically approved and appropriate use for severe pain. Community Health Accreditation Program (C.H.A.P.) Has Deeming Authority for Hospices Federal government now recognizes CHAP hospice standards as meeting or exceeding federal standards for participation in Medicare. C.H.A.P. is currently the only national accreditation organization authorized to perform Medicare, hospice surveys. California Assemblywoman Introduces Bill to Hasten Pain Relief Helen MacLeod Thomson's bill would streamline prescription of pain medications for the suffering. Reducing unnecessary "red-tape" would help patients receive pain relief sooner and assure that more physicians would prescribe the medications needed to control their pain. Insider Information about the Lack of ethics in Healthcare Testimony of Linda Peeno, M.D. Before U.S. House of Representatives on Unethical Practices of the Managed Care Industry (how for-profit motives corrupt health care in general) 5/1996 Textbooks Not Teaching Doctors About End of Life Care Review of 2/2000 article in the Journal of the American Medical Association " Criminal Act or Palliative Care? Prosecutions Involving the Care of the Dying" article by Prof. Ann Alpers posted at the website of The American Society of Law, Medicine & Ethics Dying Children Receiving Poor Pain Management Review of 2/2000 article in the New England Journal of Medicine about pain management in terminally ill pediatric cancer patients. Patients Injured by Bed Siderails Nationwide Review of 2/2000 articles from Detroit Free Press Some Facilities Do NOT Tell The Family! by Free Press staff writers David Zeman and Patricia Montemurri HCFA Representative Testifies About Status of Hospice Care and Medicare Benefit: October 1999 PBS Report on Investigation of Medicare Fraud in Hospices "Correct Care?" Transcript of a report from The NewsHour with Jim Lehrer (June 19, 1997) examining an investigation by the federal government, named Operation Restore Trust, into instances of Medicare fraud that have occurred in some hospices nationwide. Review of a 1998 Washington Post report on the effect on some Hospices when being operated by for-profit corporations which are taking over health care. Some hospices are being adversely affected by the "for-profit" mentality of some for profit corporations. Although some for-profit hospices are continuing to provide excellent care, others have failed to provide proper care. Also see article at: www.calnurse.org/cna/news/wp61498.html Reforming the Health Care Insurance Industry Guest article by Dr. Harvey Frey, MD, PhD, JD re-posted here with permission of The Health Administration Responsibility Project Click here to see the U.S. Office of Inspector General's COMPLIANCE PROGRAM GUIDANCE FOR HOSPICE INDUSTRY FROM OFFICE OF INSPECTOR GENERAL (October 1999). Hospices are coming under increasing scrutiny from the Federal Government. This report details areas where unfortunately some hospices are not complying with the regulations assuring top quality hospice care. It offers suggestions and interpretations of the regulations to further help hospices comply with the law and provide the services needed by the terminally ill. O.I.G. Fraud Alert about Illegal Hospice Kickbacks between Hospices and Nursing Homes From the U.S. Federal Register 1998 April 24;63(79);20415-7) This fraud alert from the U.S. Office of Inspector General identifies types of violations of the Medicare anti-kickback statutes seen where nursing homes and hospices might illegally "pay" each other to influence referrals to their respective agencies (rather than other agencies). Such referrals may not be in the patient's best interests. U. S. Office of Inspector General warns about some Hospices This website will always be in the process of construction, with updates and additions. If you know of interesting articles about hospice, please let us know about them. You can send us U.S. mail at:
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