Killing Them Softly

Subtitle: How 'bout some more morphine with that morphine?

It's been close to four decades now that Hospice facilities have been around. They began typically in a lovely home-like environment on a lake, or beautiful wooded area, and were affordable by the wealthy. The original concept was that people previously went to hospitals to die, but now we go to hospitals to get well. It seemed fitting to develop a serene nurturing environment in which to spend one's last days. In other words, it was a place to go to die.

The original mission was based on two promises:
1. You won't die alone.
2. You won't be in pain.

Fast forward to the present: Accusations are abundant that they are now nothing more than "legalized euthanasia", and government supported to save money that would otherwise go to hospitals and nursing homes, which are much more costly. (About that, let there be no questions, as we shall see.)

Do realize that Not All Hospices are Created Equally.

Some have actual physical facilites which might be a stand-alone home-like situation with few beds, or many are now mostly geared towards a hospital looking environment, containing up to 200 private rooms (or thereabouts.)
Some might have an entire floor for their use within an actual hospital.

There are "hospice teams" who go into hospitals and nursing homes and provide care there. There are hospice home care workers, who will render services to the patient in their own homes or the home of a relative.

They vary on admission criteria. Some might specify a life expectancy of three months or less, some the life expectancy is much less, such as a week or two. It varies. If business is slow, they might even take persons with a life expectancy of six months. But business is typically not slow. In fact, it's excellent.

What you won't see in 99% of Hospices, is IV's. If the patient cannot drink fluids on their own, they are not given fluids. Death by dehydration is very commonplace. (This bothers me.) Even at times, if the patient is provided care at home, the family care provider must agree not to provide food/fluids to the patient through artificial means, i.e. - Intravenously.

Yes, there are hospices that refuse to give any food or water and workers must sign on to that when they are hired.) The sedating "cocktails" were given to the point where respiratory function was decreased enough to cause early death.

Read more at freedomoutpost.com...

And no matter the nature of the facility or services, there is always lots and lots of morphine.
*The information below is taken from an "anti-hospice" site.

Why Hospice Is a "Protected" Industry
Well, it's pretty clear that hospice is being promoted at every level of government and by every major player in society, including the major media, big business, hospitals, nursing homes, policymakers, budget analysts and others. We've seen that hospice has been proved to save money over acute hospital care. The savings amount to billions of dollars.
"In 2009, an estimated 1.56 million patients received services from hospice." "Researchers at Duke University found that hospice reduced Medicare costs by an average of $2,309 per hospice patient."

2009 figures for hospice savings:
1,560,000 hospice patients per year
X $ 2,309 (savings/patient) per year
________________ _______ _____________
= $ 3,600,000,000 savings per year
freedomoutpost.com...

This comes as no surprise to us. One more thing about the money, is they are well compensated by Medicare. ( In researching this I saw message boards where family members said the "in-home" workers would sometimes dash in, give a morphine injection, then be out the door, and Medicare would be billed $369.00 for the visit. Family members were upset, and reported some facilities for fraud. Some workers were fired in many cases, and even some businesses closed.)

cont.

Another argument opposing Hospice from the same source as above:

..... we must be wary of those who are too willing to end the lives of the elderly and the ill. If we ever decide that a poor quality of life justifies ending that life, we have taken a step down a slippery slope that places all of us in danger. There is a difference between allowing nature to take its course and actively assisting death. The call for euthanasia surfaces in our society periodically, as it is doing now under the guise of "death with dignity" or assisted suicide. Euthanasia is a concept, it seems to me, that is in direct conflict with a religious and ethical tradition in which the human race is presented with " a blessing and a curse, life and death," and we are instructed '...therefore, to choose life." I believe 'euthanasia' lies outside the commonly held life-centered values of the West and cannot be allowed without incurring great social and personal tragedy. This is not merely an intellectual conundrum. This issue involves actual human beings at risk..."

Everett Koop, M.D. * *taken from the book KOOP, The Memoirs of America's Family Doctor by C. Everett Koop, M.D., Random House, 1991
Florence Wald and American Hospice
Read more at freedomoutpost.com...

Additionally,

The top level policymakers have decided that people will die in hospice or palliative care units, and that they will be pushed into hospice through a wide variety of means. $3.6 billion saved in one year. Think that motivates the government? That's nothing compared to the savings when the people placed into hospice doubles in the years to come. That's the plan. If patients are hurried along toward death, the savings skyrocket!

And with baby-boomers aging out, it's a win-win.

Arguments in support of Hospice dynamics

Physicians have an obligation to relieve pain and suffering and to promote the dignity and autonomy of dying patients in their care,” says the American Medical Association Code of Medical Ethics. “This includes providing effective palliative treatment even though it may foreseeably hasten death.”

Physicians and nurses have been sued, and reported to Adult Protective Service for neglect, and causing death to patients through the over use of lethal cocktails.
Hard-wired misperceptions
Although none of the physicians investigated was found at fault, most reported worry, anger, anxiety, isolation, depression and difficulty working as a result of the ordeal. Euthanasia accusations — whether voiced in the patient’s room or in the courtroom — could have a chilling effect on physicians’ treatment of dying patients’ symptoms, said John G. Carney, CEO of the Center for Practical Bioethics, a Kansas City, Mo., think tank that works to improve end-of-life care.
“I’m deeply concerned that if we don’t pay attention to the message in this article, we are going to be dealing with this issue of physicians who are reluctant to do what they know to be right because they are afraid of what people will say or that someone’s going to investigate,” said Carney, a former hospice executive director.
The distinction between aggressive pain control or the withdrawal of life-sustaining treatments and euthanasia is still lost on many patients and families, physicians said.

“These misperceptions are really pretty hard-wired and difficult to eliminate,” said David Casarett, MD, chief medical officer of the University of Pennsylvania Health System’s hospice program in the Philadelphia area. “Believe me, if there were an easy way to communicate these issues, then we wouldn’t have highly qualified physicians called before medical boards to explain their actions. To some degree, this is a cultural change. We’re far ahead of where we used to be 20 years ago. On the other hand, we can’t wait another 20 years for these things to go away.”
www.amednews.com...

My Opinion

I know it's sometimes aggravating when an OP fails to give their own opinion about a topic, so here goes. Would I willingly go to or otherwise utilize hospice services for myself or a loved one?
IN A HEARTBEAT.
I have had three up-close and personal experiences with Hospice in my city. In fact I have written those experiences up already, and perhaps will add them to this thread. I'm undecided about that as of yet. They are personal to me.
However, I would indeed want to know the reputation of the service, and try to insure that they are if fact what they represent themselves to be. As I said earlier, Hospices are not created equal. Like everything else, there are good ones and not so good ones. So looking in to learning about the service you are considering for a loved one is key.

Whether you've had an experience with a Hospice facility or not, let's hear your thoughts.

Why do we have to treat this steaming pile like a dozen roses with a chocolate heart gift?

Call it like it is. You want to be "okay" with doing away with the terribly aged. I mean I get it, but wouldn't euthanasia be a bit nicer and real?

Yes yes, I'm so heartless for mentioning it, and yet how many people talk of hospices as being "humane" until you get the real scoop?

If you can't live with them, and they can't support their selves, say a last goodbye and put them to sleep like we do our loved pets. Would you rather starve your pet that is deathly sick, or put it to sleep? I think it's a discussion we should be having.

I don't know a thing about hospice or how they are run, but this OP is so timely for me. My mother told me yesterday that she will be entering hospice care and I have to say I was feeling dubious about the process already. I appreciate that now I have some things to look at and consider while she receives her 'end of life' care.

Thank you so much for this!

a reply to: pl3bscheese
Are you saying we should be able to drive up to a clinic like we do with our pets, and have them injected with a lethal cocktail? lol! Not sure what you are saying here, but I agree it needs to discussed, and the issue needs to be confronted head-on. No pussy-footing around.

The debate, of course, is - IS it Euthanasia? Is there legalized euthanasia in our hospice facilities, and if so, should it be allowed to continue?

The Dr. Kevorkian haters of the world unite, and bring lawsuits, and bully facilities, and have put them out of 'business'.

But if and when it is recognized for what it is, these decisions should be based on humane issues, and not financial ones.
But look at where we live and what we thrive on! Of course it's going to be about money. When the government is finally broke and unable to pay expensive nursing home bills through Medicaid, BOOM! Hospice will be all rage, and ever so trendy.

a reply to: Metallicus
Metallicus, thank you, and I'm sorry your Mom is so ill. There is one thing I want you to give some serious thought to. Will they withhold fluids? Death from dehydration is not -- I just don't want to comment about it. But as long as you can hold a glass to her lips and she can drink, it's okay. But once she can no longer do that, they won't hydrate her through IV's.

Just give that some thought. Lots of Hospices have message boards. I read many comments from families while researching this thread. Those comments from family members can probably shed some light for you.........

My best to you and your Mother.

Something that astounds me about people.....

If somebody has a dog or a cat that gets sick, or injured to the point that it has no quality of life then people have no problem putting the animals down as the humane thing to do. However people? Oh no, they make them suffer to the end until their body and spirit just cannot take anymore and they finally, mercifully pass away. Many people consider their pets family, but their real family? Nope. Gonna make them suffer till the end.

I've seen old folks with Parkinsons, Diabetes, stroke, etc etc etc in such a bad condition that they aren't even cognitive, aware, or even alive without machines help. A good family friend was in such shape not too long ago. A severe stroke had paralyzed him and damaged his brain to the point that he was not even there and was chewing on that plastic peice that they give you to keep from swallowing your tongue or chewing it off. Know what his son told the doctor? He said, "You save my Dad, i don't care what you do, just save him." But his dad was not even there. My mom is a nurse and has worked at a nursing home for 35+ years. I have heard from her the same stories for years and years now.

a reply to: cancerwarrior
From my experience, by the time someone goes to a facility, they are so sick and confused, they really aren't sure where they are........ or why.

But it's all about "folkways and mores". It will have to be accepted by the majority. Of course when it comes down to the government's money, it will soon be made "acceptable" - they will see to that.

*I see I am talking out of both sides of my mouth on this subject. It's that kind of subject for me. For all of us perhaps.

a reply to: ladyinwaiting

I mean it can't be that easy. You'd see people bopping a newly ex-after-they-broke-up-with-ya on the head, signing a piece of paper, and dropping them off to get what they deserve. Nah, I don't wanna go out like that.

As for if it is euthanasia already, well I think there's kinda a time-limit on that? Unless we're considering the game going several rounds into overtime, I think it's something a little different. Assisted EOT. It's an end of term contract with your loved ones, or the government, I mean am not sure how it works in every situation, but someone finally decides you're essentially expired and speeds up the process while somehow managing to make people who should care keep a smile about it. It just seems bizarre to me.

a reply to: ladyinwaiting

While reading your thread something kept tugging at the back of my mind. It was of a memory of something I've seen before. It was a scene for a movie. Here it is:

Let's hope the people that go through it don't end up on the menu.

originally posted by: pl3bscheese
Why do we have to treat this steaming pile like a dozen roses with a chocolate heart gift?

Call it like it is. You want to be "okay" with doing away with the terribly aged. I mean I get it, but wouldn't euthanasia be a bit nicer and real?

Yes yes, I'm so heartless for mentioning it, and yet how many people talk of hospices as being "humane" until you get the real scoop?

If you can't live with them, and they can't support their selves, say a last goodbye and put them to sleep like we do our loved pets. Would you rather starve your pet that is deathly sick, or put it to sleep? I think it's a discussion we should be having.

Hey, why not save gas money driving them to the clinic and just shove them in the bin?

That's heartless.

a reply to: Skid Mark
Dearest Skidmark. I somehow seriously doubt if legalized euthanasia will lead to cannibalism. Humans are nasty creatures to consume. Full of bacteria, chemicals, we have horrible livers, and the consumption of the human brain can lead to death or so I'm told. (wooooo..........

Thanks for reading the thread though!

~~I've got to buy new speakers tomorrow, these are KAPUT! Can't listen to the vid. : (

a reply to: EA006

You're right, it's much more heartful to keep them going that last 1% without any drugs, or assistance. Just keep them around, cause you really need them to stay. That shows them you care. LOL!

Or we could drug them up, and starve them... we'll call it something close to hospital... hospice... we can totally save some monies shortening that 1% to .01%, except they lose their dignity, while we sell it to the family as being all about just that!

I mean get real, you got a better idea?

a reply to: pl3bscheese

Of course it's bizarre. : )

Kurt Vonnegut wrote a short-story for Playboy once upon a time entitled "Welcome to the Monkeyhouse". It was futuristic, and on every corner there was a "Ethical Suicide Parlor".

In the not-so-distant future, a criminal mastermind named Billy the Poet is on the loose and on his way to Cape Cod. His goal is to deflower one of the hostesses at the Ethical Suicide Parlor in Hyannis. The world government runs the parlors and urges people to commit suicide to help keep the population of 17 billion stable.

- from Wiki

I don't see it as too farfetched for our future. I have read that story, although quite a while ago. As I recall the parlors provided great food, drink, music as well as virgin prostitutes for those entering, as a lure. : )

originally posted by: pl3bscheese
a reply to: EA006

You're right, it's much more heartful to keep them going that last 1% without any drugs, or assistance. Just keep them around, cause you really need them to stay. That shows them you care. LOL!

Or we could drug them up, and starve them... we'll call it something close to hospital... hospice... we can totally save some monies shortening that 1% to .01%, except they lose their dignity, while we sell it to the family as being all about just that!

I mean get real, you got a better idea?

Those people have just as much right to be here as you.

It's a slippery slope when you start to judge who should live or die.

But i suppose for a few extra bucks.....the families would prefer that rather than time with loved ones.

Gotta be pretty cutthroat to choose dollars over a life.

originally posted by: ladyinwaiting
a reply to: pl3bscheese



I don't see it as too farfetched for our future. I have read that story, although quite a while ago. As I recall the parlors provided great food, drink, music as well as virgin prostitutes for those entering, as a lure. : )

If ya change parlor to mosque, that sounds a bit familiar?

It's not a slippery slope, you'd have to be out of your mind to apply such an extreme situation to anyone else. I'm sorry you can't look at this practically, and realize we're not going to see eye to eye. No problem. You think I'm a demon for seeking a better way. I think you're a fool for defending the current way things are done. That way is not giving someone a "right to live". It's starving them.

a reply to: EA006
Question. If the person was lucid enough, and well enough to agree to the suggestion, (which usually comes from an M.D.)
and the patient actually felt going was the best thing, would you then support it?

originally posted by: ladyinwaiting
a reply to: EA006
Question. If the person was lucid enough, and well enough to agree to the suggestion, (which usually comes from an M.D.)
and the patient actually felt going was the best thing, would you then support it?

How many MD's are suggesting this?

originally posted by: pl3bscheese
It's not a slippery slope, you'd have to be out of your mind to apply such an extreme situation to anyone else. I'm sorry you can't look at this practically, and realize we're not going to see eye to eye. No problem. You think I'm a demon for seeking a better way. I think you're a fool for defending the current way things are done. That way is not giving someone a "right to live". It's starving them.

You're right. We are not going to agree.

I'll ignore the fool comment.