(Snippets from the frontline)
Tactics forcing ICU patients onto hospice
From the outset, be worried or suspicious if:
- Your loved one is old, or has been hospitalized for a prolonged period;
- you don’t know the doctor;
- insurance is HMO;
- doctors are hospital contracted and don’t communicate well.
Doctors, nurses, or hospital staff:
- Urge you to change legal documents to DNR status;
- pressure placement of patient on hospice or “comfort care”;
- tell you your loved one is “suffering”, “uncomfortable” (who isn’t when you’re ill!), “no hope”, “care is futile”, “no quality of life”, or they will “never get back to normal”;
- make these worrisome statements within the first 48 hours of admission;
- attempt to wrestle away your legal right to make decisions for your loved one;
- urge removal of life-supporting care like medication or breathing tubes.
Fight back by:
- Demanding time, and not be forced to make spontaneous or hasty decisions;
- having a family discussion;
- getting an outside unbiased second opinion;
- making sure a Palliative Care Team is on the case (and ask who pays them);
- requesting a meeting of the hospital Ethics Committee;
- reporting them to hospital oversight agencies (eg. The Joint Commission, Health Department, Ombudsman, Medicare, Medicaid).
Money talks; you need to talk louder.
Gene Uzawa Dorio, M.D.
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