Archive for Doctors – Page 2

Hospice Strangers at Your Door

It's like a crowd headed your way . . .

It’s like a crowd headed your way . . .

In 1989’s Field of Dreams, Kevin Costner’s character famously heard, “If you build it, he will come.” If you haven’t seen the film, I won’t reveal the enigmatic “he” that eventually arrived at the baseball field built on an Iowa farm.

I usually recall the quote as “If you build it, they will come” . . . since crowds did gather at that heaven-like spot of the Midwest.

Field of Dreams was a sweet fantasy, but the reality of hospice means that many strangers will also arrive at your house. While hospice care happens away from a person’s residence, 58% (according to 2014 data) of all hospice patients remain in their homes and the “team” from hospice knocks on your front door. Part of hospice’s appeal is allowing people to continue living in the place they know best: home. For some families, that appeal is undermined by the flood of “strangers” from hospice phoning to make appointments and soon parking on your street.

If only it was one “he” that arrived at the busy “field” formally known as your lovely, quiet home!

First it may be the admitting nurse that visits. Maybe she or he actually came to the hospital, and they shared about the great things hospice will do. You heard hospice’s wonderful promise about the patient—your beloved—being able to return home. Where do you want to die? (Research I’ve read indicates 7 in 10 prefer home.) You may never see the admitting nurse again once you’ve agreed to hospice, but I hope it was a good experience. I hope she helped you understand the hospice benefits. I hope he was able to answer many of your pressing questions. Read More →

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Hospice and Pacemakers

Example of first implanted pacemaker...

Example of first implanted pacemaker…

I know almost nothing about pacemakers.

But the “almost” is the key reason to dip the big toe of my thoughts into the ocean of treatments, decisions, consequences, and patient care options related to hospice.

Pacemakers, or Cardiovascular Implantable Electronic Devices (CIEDs), help keep you alive.

They may also prevent you from dying.

The first pacemaker was implanted in 1956. It was the literal dawn of a new heart care era. Sixty years later CIEDs are commonplace, with as many as 100,000 patients annually receiving one. The devices are comparatively small, safe, operate with batteries spanning years, and allow people to:

  • Exercise
  • Blow out more birthday candles
  • Hug grandchildren
  • Create and “conquer” a bucket list
  • Walk on the beach with your beloved . . .

Near the start of my ministry—the 1970s—I’d visit church members needing a pacemaker. Going to a hospital for any surgery was scary! But soon, they’d gone from troubled health to a resurgence of life because of a silent, steady device nestled near their heart. Though an established “procedure” during my earliest hospital visits, it still seemed stunning. In her seventh decade, my mother-in-law’s doctors recommended implanting a CIED. She didn’t hesitate. Now in her 80s, the half-dollar sized device still assists her heart.

So, with my church and family history, I’m a cheerleader for pacemakers.

However . . . Read More →

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Hospice and 86 Bucks

blog-patient-doctor-communicationWhat is 30 minutes of your time worth?

For a physician meeting a patient covered by Medicare, that half-hour may be worth $86.00 in reimbursements.

Eighty-six bucks. For what?

Something remarkable is now available as a Medicare benefit. Based on guidelines approved in 2015, a person covered by Medicare can have a reimbursable conversation with their doctor about “advanced care planning,” which could include hospice. This became official in January 2016.

About seven years ago, this $86 physician-patient chat was lambasted as a “death panel,” with a faceless, faithless government discerning who’d die and who’d live. In August of 2009, former Alaska Governor Sarah Palin famously (or infamously) warned,

Seniors and the disabled “will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care.”

Seven years after the “death panel” headlines (or nonsense, depending on your view of Ms. Palin’s fears), what will the $86 get you? Read More →

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