Medicare Review of Hospices

Re “U.S. Targets Hospices if Patients Live Too Long,” March 15: Although there may be some people who outlive their prognosis, there are a great many more people who are referred to a hospice program in the last few days and in some cases the last few hours of their lives. As a hospice nurse of more than 13 years, one of the biggest problems we face is late referrals. The goal of hospice programs is to provide comfort, relieve suffering and provide closure for the dying patient and his/her family. These goals are almost impossible to achieve in 48 hours.

The second point I would like to make concerns those patients who may outlive their prognosis. If government officials would look at the cost savings provided by hospice by keeping patients out of the hospital and comfortable at home, they might actually expand the hospice benefit. An example is a patient who lived for two years on our program. She had been hospitalized frequently prior to coming on our program. After admission to hospice, with her symptoms controlled, she was hospitalized once in her two years--and that was during her last 24 hours.

Telling people they have lived too long gives strength to the Jack Kevorkian movement. Hospice is life-affirming. What message does it give when Kevorkian gets front-page news on a regular basis and hospice programs get front-page news only when the government decides we’re letting people live too long?

MICHELE D. EVANS RN

Lawndale

As a senior citizen, how proud I feel when I read that the federal government is adamantly pursuing those frauds in hospices who are using government assistance beyond their expected six months. Don’t these terminally ill patients know they are supposed to die on schedule!

WILLIAM EMERSON

Playa del Rey