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“How Hospice Became a For-Profit Hustle”


It began as a visionary notion—that patients could die with dignity at home. Now it’s a twenty-two-billion-dollar industry plagued by exploitation.


By Ava Kofman


November 28, 2022


The New Yorker, Dec 6, 2022 issue.


It might explain a bit on why we have such varying experience these days with hospice.

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NHWM,

If you live in a rural area with few health workers, you can't pick and choose. We only have the one option here. If we move an hour away we will have a different hospice provider, but no options to choose. Then, there's insurance in network system to consider and physician referral process that can narrow the choices. And as mentioned above, often when hospice is needed you are in a grief/mourning state so you follow directions more readily than when visiting a car dealership.
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An excellent hospice facility saved my MIL from dying of covid. Now, 2-years later she is 100% recovered and doing very well. Are there terrible hospice provides? Sure, just like there are terrible businesses in all industries. *Caveat emptor* ("Buyer, beware").
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NHWM - I really dislike your analogy. The problem as I see it is that people looking to bring in hospice are often operating in crisis mode and may be highly emotional, it's not like buying a car at all.
Plus why would any sane person have a reason to suspect that a service like hospice could be run by unscrupulous people, or that they may be harmed rather than helped by their choice? Telling people to do their research feels to me like victim blaming.
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Would you buy a car without test driving it? Would you buy a home without doing an inspection? Of course, you wouldn’t!

Please be just as responsible when selecting a hospice provider for your loved ones. Do proper research before choosing.
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Thank you. It took me 10 days but I have finally found a chance to read this and it was different than I expected. It's sad how money changes what's meant to be a good thing.
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Of course, services will vary, depending upon which hospice provider is used. It is a huge business. Some are for profit, others are nonprofits.

It’s the same with everything. It would be wonderful if all doctors were knowledgeable, compassionate and provided excellent care. Sadly, this isn’t always the case.

We are fortunate to have modern technology and fabulous doctors but we still have to do our own research to find the most suitable doctor for our needs. We must research hospice providers prior to using them.

We were very satisfied with our hospice teams for my brother and my mother. Many people are thoroughly satisfied but it would be foolish to think that anything across the board is perfect.

Please remember that you can always stop a particular hospice organization if you are dissatisfied and use another one at any given time.

We were very pleased with mom’s nurse in hospice. She let us know that she was going to work with another hospice organization.

She told us that we could follow her by joining the other hospice organization. We researched their organization and decided to switch to keep mom’s nurse.

This nurse worked with mom until her death. Mom loved her. She was incredibly compassionate with mom and our entire family. I will always be grateful to her for her caring service.
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When I was new to the forum the use of the terms hospice and palliative care confused me because outside of America those are synonyms not separate levels of care, and the whole industry around hospice care was foreign to me. I've been a member a long time now and I've learned.
The long, contentious thread about how "hospice killed my loved one" seemed to be filled with delusional sounding claims that made it easy to dismiss any negative experiences as more of the same. Then over time I started to see a pattern of people who willingly signed on for the "free extra help" provided by American style hospice providers without any understanding of the terminal diagnosis required.... in fact many, many people advise that a terminal diagnosis isn't necessary at all. And then there were alarming stories about inappropriate use of the medication tool kit. Yes, there are still people who are deep in denial who can't come to terms with their loved one's mortality, but there are others that need to be listened to and not immediately mocked and derided.
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You are right, 97yroldmom, reading the article totally explains at least a few of the bizarrely anti-hospice posts that we see on here regularly.

ETA: we had an excellent experience with the nonprofit hospice we used for my father’s end of life care recently.
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This link has been posted before, I believe. Okay, so I get it. Now stop.
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You need to read the article Lea. I have had only good experiences with hospice as well but this article made me more aware of what to be on the look out for.
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Absolutely right on. Absolutely SPOT on. I was so thrilled, when as a nurse I saw Hospice Mission come from across the pond. It has now become a part of the Military Industrial Complex, think profit profit profit and as little care as they can get by with. They get billions from Medicare and for that they give what is pretty much a joke for care and a dropper bottle of morphine. Having just seen my good friend to her fairly peaceful end, thank any Gods that may be for that Morphine, but that is about all she got. From RN down through Social Worker they were about as inept a crew as I have seen. I will say that my brother's hospice company several years ago in So Cal was better, but we have basically done in Hospice. And that's for dang certain. Thanks for posting, Lea.
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I can think of a lot of words I'd use to describe the excellent care my parents were given by hospice, but 'a plaything of America' would not be among them. Ludicrous.
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