Concerned about LA Times bashing of hospices
Recently the Los Angeles Times ran two front-page articles bashing the hospice industry and its regulators, with poor performance by hospices in Los Angeles County being the focus.
There have been significant performance problems reported in the hospice industry, in and beyond Los Angeles County. And the problems produce shameful consequences.
When a hospice is neglectful or provides inadequate care, the damage first is to well-being and dignity of the patient. And the damage extends to the patient’s family and friends, as they experience (and will likely never forget) the care failures in the last days of their loved one’s life.
Hospice services can be crucial to peace at the end of life
We’re concerned, however, that articles like the LA Times pieces may lead patients and families to bypass hospice services when they are truly needed.
Hospice agencies provide a valuable combination of medical, social and spiritual services to men and women nearing the ends of their lives.
Hospice services (when done well) can be crucial to peace, comfort, support and dignity for a person who is dying — as well as their loved ones.
Caring House itself is not a hospice agency. However, we witness the extraordinary positive impact hospice services can have as we work alongside the hospices who visit our residents.
Challenges facing the hospice consumer
Hospices are created to serve patients and their families. These are the consumers of hospice services and they likely face several of the following challenges:
- This is the first time they’ve used hospice services.
- They don’t know what or who to believe when presented with an onslaught of hospice marketing.
- They don’t know how to compare potential hospice services before they choose.
- They’re stressed and exhausted with the care of a person they love.
- They believe that a hospice will do much more than hospices are paid or required to do.
- They are very much at the mercy of the healthcare system and hospices, and depend on their integrity.
Families are the home-care workhorses, hospices are helpers
There is a common misconception that when someone “goes on hospice” all of their end-of-life care needs will be handled by the hospice agency. The reality is,
- A patient at the end of life merits 24/7 care and attention.
- Hospice agency staff — meeting Medicare hospice rules — will normally visit the person’s home or other care location between 5 and 10 hours per week.
- With 168 hours in a week, the family is on their own at least 94% of the time when providing care at home.
For end-of-life care at home, family caregivers are undoubtedly the workhorses. Dying at home often means the caregivers are loving but untrained family members who become exhausted and stressed by providing or supervising care for a person they love. AARP’s Public Policy Institute reports that $470 billion in unpaid caregiving is given each year in the U.S. by families and loved ones.
An end-of-life care innovation
Families caring for a loved one at the end of life need solid hospice services. Unfortunately families don’t know what to expect from hospice or how to manage the hospice services. And families are often stressed and exhausted by the care they provide. This can make it challenging to assure peace at the end of life.
Recognizing this, an innovative care model has emerged. Standing alongside and collaborating with the healthcare system, independent nonprofit homes across the U.S. (like Caring House in Torrance) have been creating home-like places to care for those who are dying. These are places where:
- Those who are dying receive services from their visiting hospice agencies (while avoiding duplication of efforts).
- Care and support are provided 24/7.
- Families get to spend meaningful time with them and with each other.
- Peace at the end of life is the standard, not the exception.
These grassroots, charitable homes are raising the standard of end-of-life care, one community at a time. They are an important part of meeting America’s growing end-of-life caregiving crisis. For more information about these homes see omegahomenetwork.org.
We help our residents and their families make better use of hospice
Since 2016, Caring House has helped almost 300 dying men and women (as well as their families) navigate and receive hospice care. Our residents typically have a remaining life expectancy of 60 days or less. Hospice team members visit and care for our residents, in collaboration with our staff.
Many of our residents and families are going through the hospice experience for the first time. It can be an anxious time for them. They want the best, but they don’t know what to expect from hospice. They don’t know who to call if they have a concern, or how to get problems addressed.
We help our residents and families understand what to expect from their hospice provider. Before a hospice service may provide care at Caring House they must sign an agreement that sets performance expectations. Among other things, the agreement requires delivery of necessary medications and equipment before the arrival of the resident. It also sets deadlines for the arrival of a nurse and completion of the hospice assessment and care plan.
Caring House helps our residents and families communicate with hospice. We are familiar with who they should call at their hospice to address concerns and solve problems. We can intercede directly and advocate, or we can coach the resident and family. And we don’t hesitate to call a hospice anytime it is appropriate, day or night.
Caring House provides a calm, consistent, professional, 24/7 care home and resources for residents and families during a resident’s stay. With our experience, we help individuals and families make better use of hospice services.
We also help hospices be more effective
The Caring House team also helps hospice providers be more effective when providing their services. Our staff is experienced in dealing with hospices, and knows what to expect and request. We understand the roles of hospice team members (doctors, nurses, social workers, etc.) and don’t hesitate to call upon them as appropriate.
It’s a team effort
Each day we’re honored to team with families to assure peace, comfort, support and dignity to their loved ones at the end of life. Hospice support is a crucial part of that team effort.
How to choose a hospice
Based on our experience working with many hospices, we created a three-page checklist that helps patients and families explore nitty-gritty questions most people wouldn’t think to ask a potential hospice in advance. You can get the free checklist here . . .
Links to the LA Times articles:
- Read the December 13, 2020, front page article (published earlier online)
- Read the December 14, 2020, front page article (published earlier online)
- Read December 24, 2020 follow up article on Federal legislation on regulating hospices
About Caring House
Our five-bedroom home is located in a peaceful residential neighborhood in Torrance. We’re the only nonprofit non-medical home in Los Angeles County dedicated to care for people at the end of life. We purchased our home thanks to community donations. Our independent nonprofit is supported community donations and payments by residents and families. The staff benefits from the strong support of volunteers.
For more information see the FAQs page at yourcaringhouse.org or call us at 310-796-6625.