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Hospice: The Best Kept Secret in Healthcare

Article submitted by Jerry Kopack

Boulder, Colorado - A few weeks ago I was sitting in my primary care physician’s office getting a routine check up. In between blood pressure checks, the cold stethoscope on my back, and the rubber hammer bouncing off my knee, we started talking about my activities, interests, etc. When he asked “what do you do for a living?” I was proud and anxious to tell him that I am co-founder of Family Hospice, a family owned hospice serving Boulder County. Now, I realize that this wasn’t the most opportune time to discuss work, but, well, he asked … and how often do you really get the opportunity to get the undivided attention of a physician for 14 minutes?

After gagging on the wooden popsicle stick and saying, “ahhhhh”, I proceeded to ask his opinion about hospice and, unsurprisingly, he knew the basics but didn’t have much specific knowledge of the topic. I say “unsurprisingly” because I have learned that in talking to hundreds of people over the past 7 years since starting Family Hospice, that hospice really is the best kept secret in healthcare. I, like everyone else who is part of this industry, work hard every day to change that distinction.

Knowing that at this point, I realistically only had about 7 minutes left during my appointment, I started with what I call “Hospice 101”. I was able to skip some of the true basics. He knew that in order for a person to qualify for hospice, a physician had to certify that the patient has a life limiting illness and that if that illness takes a normal trajectory, the prognosis is 6 months or less. When he asked, “what happens at the end of 6 months if the patient is still alive? Does their hospice benefit expire?”, I knew the tables had turned and I now got to play the role of educator.

At this point, I politely took over the conversation. It felt rather empowering to be providing education to a physician in his office! (I mean, really, how often does that happen???) I informed him that “at the end of 6 months, the patient must be re-certified. In fact, the patient must be re-certified after the first 90 days, the second 90 days, and then each additional 60 days. There is no limit to how long a patient may remain on service as long as the physician continues to certify them.” I also noted that hospice does not mean ‘giving up hope’. It means living life fully and with dignity. Sometimes patients simply improve to the point where they no longer ‘qualify’ for hospice. We have actually had patients “graduate” from our hospice because their condition improved so much.

“So why is hospice the best kept secret in healthcare?” he asked. I continued by telling him that “while a patient is on hospice, they receive regular nurse visits to manage pain and symptoms, hospice aide visits for personal care needs, and support services from a social worker and chaplain. In addition, they receive 24 hour on-call availability from a registered nurse so that if there is a crisis in the middle of the night or on a weekend, a nurse will make a visit to them. Also, all of the medications, medical equipment and supplies related to their hospice diagnosis are covered as well. Finally, all of this is provided in the comfort of the patient’s home. Yes, a patient can remain in their own home.”

“How much does all that cost?” he asked.

“This is why hospice is the best kept secret in healthcare!” I replied, almost excitedly. “All of these things are FREE under the hospice Medicare benefit. Yes, FREE. No pay, no co-pay, no deductible, and the patient never has to leave their home.”

“Wow, that’s incredible!” my physician exclaimed rather surprisingly. “So, since this is a Medicare benefit, then hospices are run by the government?” he asked.

“Actually, there are thousands of hospices in operation across the country and probably a dozen or so that serve the Boulder County area. The government does not run hospice. They only provide the funding for them. Each one is its own entity”, I responded.

I was anxiously anticipating his next question and had to temper this enthusiasm when he finally asked it. “How does one choose a hospice and what makes Family Hospice different?” he inquired.

“Family Hospice is a family owned and run hospice, located in Boulder and serving Boulder County. We are not a large corporation. I started Family Hospice in 2005 with my mother and step father with the goal to provide a truly personal hospice experience with the closeness, support, and nurturing of a family. Hospice can be a very challenging experience but with Family Hospice, our goal is to treat patients and the patient’s family as members of our own family. Since hospice is a Medicare benefit, Medicare mandates that a patient need only receive a minimum of 1 nurse visit every 2 weeks to monitor their symptoms. At Family Hospice, our patients see their nurse AT LEAST once per week, and most patients receive 2-3 nurse visits per week depending on their needs. With this increased contact, we are able to more closely monitor a patient’s symptoms and form that ‘family’ type of connection with them. This is something that we feel is critical during this phase of their life. We also have 2 full time hospice physicians on our staff that will make house calls, even on weekends. But really, all hospices do amazing work and when the time arises, the key is to find a hospice that you feel a connection with.”

A knock on the door came. Apparently our 14 minutes together were up. Before I had the opportunity, my physician thanked me for my time. A week later I received a phone call from him with my results. I was happy that that my checkup came back normal and I take comfort knowing that should the time arise, there is a program called hospice for me.

Posted November 2012 on