Yesterday, I received this email from long-time local support group member Denise Dagan. She’s referring to an article in “The Week,” which is an excerpt from a longer article in the January 2016 issue of “Harper’s Magazine.” The articles are about a medical oncologist’s use of the Dying with Dignity law in Oregon. Then the oncologist is diagnosed with cancer. Denise says that despite a couple of errors, the excerpt is “a well written reminder that we should all think about what is important to us when it comes to end of life care and/or treatment.”
In her email, Denise also discusses for-profit hospice and non-profit hospice, plus Dr. Gawande’s book “Being Mortal.”
Thanks to Denise for sharing!
From Denise Dagan:
The Week magazine has a nice excerpt from a Harper’s Magazine article about an oncologist using Oregon’s dying with dignity legislation. It doesn’t mention palliative care; and it should. [Perhaps the full length article does.] It also implies, in the second paragraph, that you can’t die at home if you are enrolled in hospice care, which is patently false. Otherwise, it’s a well written reminder that we should all think about what is important to us when it comes to end of life care and/or treatment.
A more fully explored text on this topic is Being Mortal: Medicine and What Matters in the End, by Atul Gawande. The first half of the book mostly explores the evolution of housing and assisted living options for seniors and the disabled. The second half follows the author’s father’s end of life experience. The upshot is the author’s personal growth as a physician in helping patients understand the medical options available to them and navigate their own end-of-life path. He is a huge proponent of palliative and hospice care, and has some remarkable statistics from the insurance companies which support palliative and hospice care universal availability. He believes every physician should be better educated in explaining the benefits of these services to their patients.
Personally, I think many people don’t realize some of the hospice services are for-profit businesses. Articles like this one from CBS Money Watch discusses the pros & cons of for-profit and non-profit services.
Principally, for-profits market themselves toward long-term care patients, like those with dementia, so they can bill MediCare longer. Since their focus is money, they may provide more limited visits and actual services with staff who have less training than Non-profits, which don’t do much marketing, take all patients, and tend to provide longer visits with more qualified staff. Actual studies have not shown significant difference between profit and non-profit hospice care, as found in this abstract from the NIH:
Here’s a link to the full article in Harper’s Magazine from January, 2016:
Here is the link to excerpt in The Week: