Hospice under fire.

In the early days of the Medicare hospice benefit, which was designed for those with less than six months to live, nearly all patients were cancer victims, who tended to die relatively quickly and predictably once curative efforts were abandoned.

But in the last five years, hospice use has skyrocketed among patients with less predictable trajectories, like those with Alzheimer’s disease and dementia. Those patients now form a majority of hospice consumers, and their average stays are far longer — 86 days for Alzheimer’s patients, for instance, compared with 44 for those with lung cancer, according to the Medicare Payment Advisory Commission.

When I worked at a faciity for people with dementia, they always called in the Hospice people when we didn’t think there was any hope…and you know what? The residents almost always got better; they didn’t die. I don’t know if its the medications that are used under Hospice management, but I saw many, many residents actually get better with alertness, eating, ADL’s, behavior. Of course many other residents used Hospice services for it’s intended purpose- to make the experience of death as dignified as humanly possible.

Interesting article about how it’s all changed from what it started out as.