Hospice Benefits Aren’t a Free Lunch, However…

Of course, there’s no such thing as a…

I arrived at the hospital to tell a gentleman about hospice care and benefits. According to his medical chart, he was ninety-seven years old. Before meeting him, I calculated he’d been born not long after the turn of the century. As in the prior century, when Teddy Roosevelt became president and horses represented a key transportation choice for most Americans.

Many years ago, I served as a hospice chaplain. At some point, my boss had asked me to tackle a new responsibility: introducing hospice to potential patients. Why me? Was it my loud voice? Or maybe it was because, as a pastor who’d preached quite a few sermons, I can give the impression that I know what I’m talking about?

Entering our potential patient’s hospital room, I glanced at the first bed where a young Asian-American man returned my nod.

Definitely not my patient!

The other patient perched on a chair in the corner, a tray of food before him, chatting with people I guessed to be his daughter and wife. Drawing closer, I thought this guy could pass for seventy-five. Could the chart be wrong about his age?

When I told him I was there to provide information about hospice, his wife and daughter introduced themselves and settled around his chair to listen. Not long after starting my overview of hospice benefits, the guy appeared to fall asleep. His eyes closed, his head bowed; he’d become a hospital-gowned statue. As I talked louder and frequently used his name to include him, he was now acting more like someone only three birthday cakes shy of the century mark.

He was an old man. He was nearing death.

I concentrated more on his family. Right before I planned to inform them about another aspect of hospice care, the nonagenarian abruptly patted my arm and said, “Just tell me this one thing, young fella, will Medicare cover all of what you’re talking about? Is it free?”

Whoa! Don’t think the elderly aren’t alert! Don’t think the dying can’t think for themselves!

Boy had I been wrong—he’d heard me “preach” on nursing visits and medications and the medical equipment available for home use. He’d heard me explain a home health aide could help bathe him and, if they wanted a chaplain like me, one would be there to support his family and him.

My potential patient might’ve appeared deep in Slumberland’s zip code, but all along he’d been pondering hospice options.

“Is it free?” he had asked.

“Yes.” And I also said no. “Hospice won’t cover everything, because–”

“But the stuff you mentioned, like a nurse coming to the home, those new medications getting covered, someone bringing a porta-potty thingamajig to be near my bed, that’s gonna happen?”


“Good, that’s all I needed to know. Tell me the rest of what you gotta tell me as long as Medicare will cover that good crap.”

He reverted to doze-mode.

But I was confident he heard everything. I think he also knew, long before I introduced myself, that hospice benefits weren’t free. Some items wouldn’t be covered. And he’d also spent his life having a portion of his earnings taken from decades of paychecks for a future that was now his present. Furthermore, all but the most foolish person knows there’s no such thing as a free lunch . . . and my ninety-seven year old did not qualify as a fool!

I assumed he mostly wanted reassurance Medicare would pay for the basics. After all, he desired to be home and settle into his own bed. But as I shared about Medicare’s coverage, with all of its billions of dollars paid in and paid out, I think he and I were talking about another kind of free.

Way back in the 1960s, the singer Janis Joplin famously crooned, “Freedom’s just another word for nothing left to lose.” But this free, his free, embraced faith and family. I believe, as he touched my arm, he was really asking, “Can I trust you? Are you telling me the truth?”

He knew his lifespan could now be counted more in hours and days than in seasons and years. Can hospice help him be free enough where being home and spending his remaining time with a loving family could be gained? Those “free” things were still part of his wide-awake hopes and plans.


The old guy wasn’t dozing. He desired to gain the most important things.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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