How Vulnerable Patients And Families Are!
(Danger Of Being Exploited By Hospices)
When a physician hands out a terminal diagnosis, it is often
devastating to the patient and family. There are so many things
we may have wanted to do, to share, to say, to experience...and
now, in a moment all of that has changed. There are regrets,
dashed hopes and dreams. In some cases, the patient is elderly
and has lived a long and full life; sometimes it is easier to
accept in such a case, but not always. Even then, there is often
much grief and sadness. Out of fear of death, some families and
patients can deny the imminence of death all the way up till the
very end.
In the midst of a terribly upsetting confrontation with our
own mortality and the death of our loved ones, patients and
families must make numerous decisions about:
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what type of health care the patient wants,
-
where the patient is to live,
-
who will help take care of him or her,
-
what efforts will or will not be made to revive him or
her,
-
is a Will made out?,
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how will we deal with being alone?
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what type of funeral arrangements should be made,
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what will happen after the death of our loved one,
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will we need to move to another home?
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how will the family manage financially, and so on.
For many, it really is quite overwhelming to deal with the
impending death of a lifelong family member. Religious faith can
help soften the blow, but it is still difficult. When patients
and families turn to hospice, they are quite often desperately
seeking answers to very urgent questions. The hospice has an
ethical and legal obligation to meet the needs of the patients
and families: that is the mission of hospice...to work from the
heart in a spirit of compassion. Hospices should be providing
counseling and information necessary to assist the patient and
family make all the decisions necessary to deal with the terminal
illness.
Because patients and families most often do not know the laws
governing hospice care, unethical hospice administrators could
arrange for hospice staff to mislead them about any aspect of
hospice, and the patient or family would not know if what they
were told was the truth or not. We trust health care staff,
nurses, doctors, and counselors...licensed to serve
professionally, and we believe they would never lie or deceive
us...of course. When patients and families find out that they
have been deceived by health care professionals, outrage is an
understated description of how they feel.
But more often than not, the hospice staff are misled by
administrators who feed them misinformation about the
regulations, and then the staff do not realize that any fraud or
exploitation is going on...even though their instinct tells them
something's just not right. Once hospice staff are
misinformed about the standards, it is easy for hospice
administrators to have the staff do the "dirty work"
for them. If the agency is caught by the police or government
inspectors, they blame the staff and deny any official
involvement by the agency administrators.
Because it is common for patients and families to be caught up
in the emotional upheaval of the moment, hospices can easily
manipulate families or patients into facilities against their
will, or simply not provide certain services which the family or
patient is not aware of, even though needed. Some rogue hospices
sorrowfully tell the patient that they can't provide
private-duty around-the-clock nursing, even when the law requires
the hospice to provide continuous nursing care in a crisis. These
rogue hospices then refer the patients to private duty nursing
agencies owned by the hospice itself and charge the patient for
services already being reimbursed by Medicare, Medicaid, or
private insurance...or the hospice may bill at the routine home
care level of care to government and have the patient pay for the
continuous private duty nursing care (another form of
double-billing).
Why patients and families are vulnerable is not difficult to
understand. But why hospices would exploit the very patients and
families they serve, that is intolerable as well as illegal.
Those hospices which provide quality hospice care cannot
understand the fraud that occurs in other hospices. Most staff
are so dedicated and caring. But certain hospice administrators
are white-collar criminals who happen to have entered hospice
administration as an opportunity for self-aggrandizement and high
pay. Knowing what services should be provided will help you avoid
being exploited.
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