Crises in End of Life Care

Hospice care is intended to be palliative, handling the pain management of a patient’s chronic illnesses and addressing the end-of-life issues that are inherent with incurable conditions and diseases.

Bloomberg News has a fascinating and troubling article on hospice facilities that are neglecting elderly patients, illustrated by the story of a 91-year-old California resident who was wheezing and losing consciousness in a nursing home. Her son contacted the hospice provider, Vitas Healthcare, requesting the facility move his mother to the hospital and was told “Our job is not to prepare them to live…Our job is to prepare them to die.”

The man called 911; in the emergency room, a doctor removed 11 maggots from an open wound on his mother’s big toe. Shortly thereafter, she died of a sepsis infection brought on by gangrene in her toe and poor circulation.

Vitas, the biggest company in hospice care, has denied negligence in this incident, stating “The purpose of hospice care is not curative care. It is comfort care. ”

Vitas, which projects $1 billion in revenue this year, is currently under federal investigation for “engage(ing) in an extensive scheme” to “defraud the Medicare and Medicaid programs of potentially hundreds of millions of dollars” by falsifying records and hospice certifications, and for billing for services it didn’t deliver, according to a federal court filing.

Read more about nursing home abuse, or learn more about preventing abuse and neglect in long-term care facilities at the National Center on Elder Abuse.