Christmas Tea

On Wednesday December 21st, Blue Skies held a Christmas tea at Kindred Care in Dyer, Indiana. Forty patients, both hospice and non-hospice, attended. Volunteers made goodies that they served with tea. There was also a raffle. The winners received Christmas blankets and holiday jewelry.

Moving Story of L.A.Man Highlights Hospice

The Los Angeles Times tells the story Steve Lopez, a 57-year-old family man, who was shocked to receive the sad and troubling diagnosis of cancer in his kidneys. His age and his love for his family make his resistant to die. The emotional pain and trauma with which he and his family must suffer is heartbreaking, but all too familiar to many families who elect to enroll a loved one into hospice treatment. "I'm not ready to go, but I'm prepared," Lopez said.

His story also addressed some of the misconceptions about hospice care, while demonstrating its true value:

Ramos was offered a chance to receive hospice care with a focus on palliative measures. Those are ominous-sounding words to a lot of terminally ill patients, and Ramos was no exception. The picture that popped into his head was of him dying in some kind of nursing facility with the hospice team at his side.

No, he was told. He could go home and be with his family. A doctor, nurse, social worker and chaplain would make house calls, care for Ramos and educate and support his family. If there were emergencies, he could still go to the hospital.

The fact that Ramos has rallied a bit since leaving the hospital in September does not surprise his doctor.

"All of our patients prefer to be home," said Dr. Peter Khang, chief of geriatrics and palliative medicine. He noted that in addition to familiar surroundings, home cooking and the love of family, this kind of care means fewer stressful, exhausting trips to the clinic or hospital.

Susan Enguidanos, an assistant professor of gerontology at USC, specializes in end-of-life care and has helped monitor Kaiser's in-home treatment programs. She said a study of Kaiser's in-home palliative program about 10 years ago showed a 45% reduction in patient costs due to the avoidance of emergency room and hospital visits, and more important, there was also a sharp increase in patient satisfaction. Other such studies, she said, have shown that 71% of palliative care patients die at home, as most people say they would prefer to do, as opposed to only 50% of those not in such programs.

The national implications are enormous, given that a large portion of the debt crisis in the United States is due to rising healthcare costs. Enguidanos said roughly 27% to 30% of total Medicare costs go to the 10% of patients who are dying, and she estimated that by placing greater emphasis on in-home care, Medicare could save 25% of what it spends on patients in the last year of life.

So why isn't this front and center in a presidential campaign season? Because many people don't understand that hospice and palliative care are about both living and dying with dignity, and because any civil discussion about end-of-life policy is more difficult since Sarah Palin uttered the words "death panels." Enguidanos and the medical staff at Kaiser — including Drs. Richard Brumley and Nancy Gibbs — told me they hope more research and education will convince the public and politicians that lower costs and greater patient satisfaction are both possible with greater emphasis on in-home care.

The financial benefits of moving America toward wiser and increasingly mature decisions regarding hospice and end-of-life care are clear, and measured in direct terms by many reputable organizations and medical professionals, as indicated by the Los Angeles Times.

The dignity and humanity of Lopez, his family, and many others in the same devastating trial of strength, love, and compassion, are invaluable and immeasurable. Hospice hels preserve them.