In The Post’s Perspective section of March 16, Colorado Voices writer Jackie Avner was courageous to share her story of her family’s hospice experience. Now I’d like to share my experience with end-of-life care.
My brother died in excruciating pain as physicians continued to “treat” him. My mom died at home with hospice brought in only during the last five days of her life. My step-mother died at home with hospice care during her final three days. I was present for each death – learning to accept the truth about end-of-life.
As Avner notes, hospice is an incredible gift but from my experience, it would have been an even greater gift had my family members been allowed to receive the benefits of hospice care earlier in the end-of-life process – to relieve pain and bring comfort. This is what is called palliative care – an umbrella term for any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than halting the progression of the disease or providing a cure.
The Denver Hospice is leading the way nationally in providing palliative care to our patients – in their homes, in long-term care facilities and in hospitals. In fact, hospice itself is a form of palliative care but the primary distinction is based on the financial reimbursement system. Medicare and private insurance companies will compensate for hospice care at a significantly higher level than they will for other forms of palliative care.
And in order to qualify for hospice benefits, Medicare requires a diagnosis that states the patient will die within six months, and that there will be no life-extending efforts. This creates a situation where most people who are eligible to benefit from palliative care wait until their final days.
The Denver Hospice, the area’s largest and oldest non-profit hospice, serves an average of 500 hospice and 200 palliative care patients and families each day. The median length of stay in our hospice program is 16 days. The typical patient and family barely begin to reap the benefits before the patient dies. We are working to shift that paradigm.
Rather than limit who receives this level of care by not allowing access to all with a terminal illness, I propose we reinvent the financial reimbursement model to appropriately compensate for care of advanced illness earlier in the end-of-life experience. Studies show that would reduce the overall cost burden to the health care system – even with continuation of some life-extending treatment. More importantly, investing sooner will ensure quality of life at a most critical time.
Denver – considered to be the Baby Boomer Capital of the U.S. with a boomer population of 33 percent vs. a national average of 27 percent – is the place to lead the transformation. As boomers approach age 65, we must find creative solutions to ensure we are prepared to offer care in a financially viable way and open doors to all who need our care.
Diane Murphy was a former long-time volunteer with The Denver Hospice until joining the staff last year.
