Changing the Way We Die

Changing the Way We Die❮Reading❯ ➵ Changing the Way We Die ➭ Author Fran Smith – There’s a uiet revolution happening in the way we die More than 15 million Americans a year die in hospice care—nearly 44 percent of all deaths—and a vast industry has sprung up to meet the grow There’s a uiet Way We eBook ´ revolution happening in the way we die More than million Americans a year die in hospice care—nearly percent of all deaths—and a vast industry has sprung up to meet the growing demand Once viewed as a Changing the PDF/EPUB or New Age indulgence hospice is now a billion business and one of the most successful segments in health care Changing the Way We Die by award winning journalists Fran Smith and Sheila Himmel is the first book to take a broad the Way We ePUB ☆ penetrating look at the hospice landscape Changing the Way We Die is a vital resource for anyone who wants to be prepared to face life’s most challenging and universal event You will learn— Hospice use is soaring yet most people come too late to get the full benefits— With the age tsunami it becomes even critical for families and patients to choose end of life care wisely— Hospice at its best is much than a way to relieve the suffering of dying It is a way to live. At this point in my life I have been facing some major decisions and most are very difficult Many have to do with my elderly grandmother that is suffering from the disease known as Alzheimer's It has destroyed both her mind and her spirit and has left a shell of a being that we hardly recognize At this moment in time we are in the process of preparing her for hospice In desperation I have sought out information from my local library since my other relatives are deceased I never thought that I would have to make end of life decisions for a grandparent at the age of 35 This book has been a tremendous help for me and has allowed me to ask uestions of both the home health nurse and hospice nurse It has brought comfort in the idea that I know that my grandmother will be given an opportunity to transition with dignity I support the concept that elders should be allowed to pass away in their home if possible If you have a loved one that is entering the hospice program than this book is a must read There is so much stress involved when it comes to the end of stage life that it really helps to have some extra advice on the side Death does not have to be scary for either the family or the person transitioning I highly recommend this book to both caregivers and family members Changing the Way We Die Compassionate End of Life Care and the Hospice Movement isn't a book I would have read on my own — I generally stick to fiction and some war history — but it was written by two people I have respected for many yearsFran Smith whom I first met at the Orange County Register about 25 years ago and Sheila Himmel whom I met at the San Jose Mercury News 10 or 15 years ago are both excellent reporters and writers and I respect both of them very muchSo I picked up this book expecting it to be well researched and well written and was right on both countsAnd it is fascinatingI am old enough to remember when the idea of hospice care wasn't widely discussed For many it seemed like some kind of new agey hippie thing Would candles and incense be involved?But that's not the caseAs Smith and Himmel describe in Changing the Way We Die hospice takes many different forms and at its best it's all about helping the dying person be comfortable and even happy in the final days months or yearsWhen people acknowledge that dying is not 'if' but 'when' the essential uestion is What do you want to do with the rest of your life? they write in the IntroductionA fine uestion for us all really whether death seems imminent or notBut for people who know death is coming sooner than later it becomes a bigger issue Do they spend the last bits of their lives in hospitals surrounded by noise bright lights and machines as doctors attempt every last ditch maneuver to keep them alive or do they spend the last part of their lives in comfort using palliative care to control the pain perhaps enjoying a nice window view of a garden and maybe with a loved one holding their hand?That is over simplifying to keep this review short But Himmel and Smith have many examples of such events in much greater detail Case in point Rusty Hammer who'd been mayor of Campbell California when he was 21 and went on to become a successful business executiveWhen he turned 50 he started having back pain A scan found a mass of tumors He had acute myelogenous leukemia and only a 20 percent chance of living another five yearsHe was a fighter and of course doctors are in the business of trying to extend life so what followed was months of hospitalizations and a barrage of medications and treatmentsThen came a cascade of complications from diabetes induced by the steroids he was taking to pneumonia to a staph infection from a catheterHe wanted to continue treatment But Pamela his wife was worn to the bone he could see and he felt responsible 'My illness was sapping Pamela's life' he later wroteSo he hooked up with Hospice of the ValleyWith hospice care Rusty Hammer's symptoms were kept in check Doctors nurses and medicines came to the house The doctor stayed an hour each time — an hourRusty set up shop in his recliner with his computer printer phone and side table friends and family coming and going talking about politics His children Gerald and Jennifer visited often The living room became a salon and he presided over it with the same charm humor and intellligence that had gotten him elected to the city council so many years earlierHis last words were I love you to Pamela and he nodded offFor a long time afterward even as she faced her future and joined a hospice sponsored bereavement group Pamela could not help but look back and think about how much suffering Rusty would have avoided had they considered hospice soonerThis fine book goes into the history of hospice — from inns on the European trails to the Holy Land to St Luke's Home for the Dying Poor in 1893 in London to Saint Rose's Free Home for Incurable Cancer in the 1890s in the slums of Manhattan's Lower East Side to Cicely Saunders' modern efforts in Great Britain in the 20th century to the big business and big politics of hospice in the United StatesWhere once hospice was little known now some 44 percent of American deaths occur with hospice care About 15 million Americans a year die that wayClergy nurses social workers doctors and true believers drove the early hospice efforts Smith and Himmel write It's likely there was not a marketer or a finance expert among themThese days corporations fight over market shares of dying people although there are still smaller local operations across the nationlooking back from the twenty first century — when a partisan furor and nonsense about death panels erupted over a proposal by President Obama to allow Medicare to reimburse doctors for time they spent simply discussing end of life options — it is almost impossible to imagine how the hospice benefit made it through Congress It was the only new health service entitlement created during President Ronald Reagan's first term It also was the only Medicare benefit crafted not only to improve patient care but also to cut government spending In the end advocates convinced lawmakers that hospice care would be cheaper for Medicare than paying for the aggressive treatment that so many patients received up until they diedOf course politicians and bureaucrats have often found ways to keep Medicare funded hospice care from being as effective as it could be For instance a patient must be certified by a doctor as likely to only have six months left to live But hospice care often extends the life — and the uality of life — for patients so if the six months passes and the patient is still alive a re certification is needed and over the years the paperwork for that has gotten much worseIn researching this book Himmel and Smith write we observed a doctor spend eight hours over the week — a full day essentially — reviewing the charts of patients reading the notes of the nurses who admitted them and signing off on forms called Initial Certification of Terminal Illness Doctors of course should approve hospice admissions but at least one uarter of the patients had already died by the time their paperwork reached this physicians' deskWell corporations profiting from death is nothing new and bureaucracy making smooth roads bumpy is also old newsYet as this book demonstrates hospice care lives on in a number of ways from prison hospices to Hospice of Santa Cruz which has made a point of reaching out to the Spanish speaking farm workers of nearby WatsonvilleThe hospice system is far from perfect Smith and Himmel write but the hospice philosophy has changed our country for the better It has given us permission to talk about drying and a language to advocated for the care we want for ourselves and those we love Hospice has shown that it is never too late to answer the uestion What do you want to do with the rest of your lifeAnd it is never too early As a writer on end of life care I have read far than my share of books on hospice care This book by Smith and Himmel stands out among am excellent and growing field Illuminated by stories from patients family members nurses physicians and hospice volunteers and staff this book busts many of the myths about hospice care and puts a very human face on the work that hospice does As a hospice volunteer for many years I will never tire of the stories about how hospice helped people to live their lives well until the end What I didn't anticipate however was the in depth research and shocking stories about the rise of the for profit hospice industry In their brilliant chapter Dying for Dollars the authors demonstrate the rapid and dramatic transformation of hospice services following the introduction of the Medicare benefit As a Canadian I am completely shocked and disgusted by the effective take over of the hospice movement by investment capital However the book provides lots of hope in detailing the stories of the dedicated men and women who commit their lives for helping to relieve people's suffering and enrich their lives Pick up this book Share it with friends Talk about end of life care This book will inform your discussions This is an excellent book about hospice what it is how it works and who the people are that use it The book covers the founding of the hospice movement the ideals espoused in hospice and how to get benefits for your loved ones when they need hospice care This was very helpful when making decisions for my aunt Informative and interesting This book covers the beginning of hospice care stories of patients and families left behind the business of hospice and includes interesting facts about hospice even extending life in some circumstances I’ll be reading books like this When Smith and Himmel lost their fathers around the same time one of them had a good experience and one not so much  They decided to do some research on hospice and attempt to find out just how successful hospice care is  This is a comprehensive look at hospice from four perspectives first examining the philosophy and history of hospice care  This section is followed by examining hospice from the experience of the patient and then of the survivors  Finally the history and role of providers of hospice care is examined  These four sections are told both factually with resources listed and illustrated also with personal stories and experiences which makes for some very interesting reading  You will read stories about marriages that come out of survivor groups as well as medicare regulations  A LOT of information is packed into this very readable 200 page book  Although I have studied death and dying it was years ago in college and I wanted an update because my mother is currently dealing with ParkinsonsLewey Body and has been in hospice care for five months in an assisted living facility When I first became aware of hospice it was mostly a volunteer non profit service; I had no idea that medicare covers it todayThe most important aspect of hospice philosophy addressed is that the patient gets good palliative care and makes her own choices about how she wants to live the rest of her life   We will all die but we can make SOME choices IF we do so early enough about our deaths  That is do we want to be in a hospital a hospice setting or at home  How do we want to utilize pain meds who do we want as visitors or to care for us physically and what kind of life extending care do we want  These are addressed from the patients' perspective and experience as well as the family's with hospice workers to clarify choices and options and help smooth family disagreements Hospice means the end to curative care and the movement to palliative care which can be difficult to face and for families to reach agreement aboutThe survivors are offered extensive support during and after the death of the patient for a minimum of a year depending on the programThe last section of the book about providers was very interesting to me  It traces the growth of hospice from the work of individual usually voluntary workers to its current state as big corporate business  When one particular hospice worker came to believe that the movement could not survive financially without support he first worked to develop rules and regs for the industry and then pushed for legislation for medicare to cover hospice care  When that passed and it became evident a LARGE amount of money was about to become available investors and corporations became interested in getting their piece of the hospice pie and companies like VITAS were formed  It is the largest one today and the one that provides services for my mother  Of course there has also been a field day for the attorneys and than  one lawsuit has been filed against VITAS and other providersI found the financial aspects of hospice and medicare to be VERY interesting especially because I recently saw an article in the press about hospice care draining large sums of money from medicare  After reading this book I don't believe that to be the case  There are many aspects of finances that come into play and are examined by Smith and Hillel who cite their sources  It appears that hospice care actually costs less than not having hospice care  Interestingly patients who use hospice early enough actually live longer by 37 days  Medicare is no longer paying for curative treatment and there are typically no long painful expensive and repeated trips to the hospital  This is probably clear to anyone who has ever received a hospital bill  In my mom's case she was repeatedly falling and every unobserved fall in her facility meant a trip to the ER due to their regulations  She did not need ER treatment and the experience was frustrating to everyone involved  from the responding emergency personnel who were by then on a first name basis with her to the ER personnel and docs not to mention my mom who hated it  Now if she falls several safety measures have been put in place rather than a 911 call her facility calls hospice and the nurse comes out and assesses her and she gets to stay at her place  There is a lot to the financial piece and the story is well told by the authors and makes interesting reading  It is a uick course in how medical care and philosophy become institutionalized  Hospice is considered by many to be the most successful part of the US health care system and many wonder why we can't extend some hospice policies to the rest of the systemThis book was a five star read for me to my surprise  I also found it hopeful and encouraging  We may not have control over our deaths but hospice can give us choices as to how we live out our remaining timeThis review is from an Advanced Reading Copy I received from the publisher I think anyone caring for an aged loved one or a loved one who has an illness that will probably result in death should read this book I did not know much about the hospice movement before reading it but now after reading it I have a whole new understanding and appreciation of this important movement The authors have presented with many compelling and interesting stories as well as great sound research and investigation a very good primer on what hospice care provides its history and its future I liked the approach of the authors took throughout the book as well as the way they brought home the true meaning of the hospice movement and its impact on our society I was particularly interested in the fact that the movement involves the whole family not just the patient involved and that the movement advocates palliative care as the only real way to go I know I would prefer this This book can hopefully shift attitudes and ideas people have about end of life care for themselves or for loved ones because I think it is a necessary shift based on what I am seeing around me Yes the basic overall subject of death can be depressing but it is one we all must begin to think about sooner or later Having this book as a reference can definitely help in the decision making process I think anyone who wants to explore this subject further or who wants a basic understanding andor understanding of what hospice is all about should read this book In addition medical professionals and social workers who deal with these issues should definitely read this book as it can provide great information and fill in any gaps they may have I received this from Goodreads to read and review I've heard of hospice care for a good many years now but was never sure exactly what it meant As someone nearing retirement myself and with several aging family members I was very glad to read this book and learn for my own sake and for theirsThe book contains a solid history of hospice care as well as information about what it generally does and does not do and various accounts of people who it has helped I think the things that struck me the most is that it tr5ies to include the entire family in the process not just the patient AND that most hospices advocate strongly for palliative care; they are not concerned that someone with only weeks to live might get hooked on opiates and so would rather let them suffer I know that would be a relief to me if I had a painful and fatal diseaseA small uibble the structure of the book could have been cohesively organized In some chapters it veers from modern practice to history to case study and then veers around again I found that awkward to readStill it's a very valuable book that gives a clear look at the current and historical hospice movement and what it means to individual people and familiesNote that I got an ARC of this book from VIVA Productions I received this book for free as part of LibraryThing's Early Reviewer program; this review is not affected by this factI'm not sure enjoyed is a good word for this book since it's definitely not an easy read but it is worth reading and I'm glad I did I appreciated the use of different families' stories although some were heartbreaking and really hit home having experienced the death of my grandfather in law in a less than ideal way The information on the origins and original goals of hospice was fascinating and led me to search out other information there's a fascinating documentary about Bethesda Hospice produced by the BBC that I highly recommend if you can find it I've been encouraged to startcontinue conversations with my wife parents and in laws about what we really want to happen as time goes on Not easy but necessary Very InformativeDeath and dying don't have to be taboo Speak with your loved ones gently as this subject matter may be a safe subject for some and scary as hell for others Any advance planning that is shared are steps in the right direction and will make it easier in the long run Book was very informative on the birth of and trials of hospice Bottom line it is all about the patient the family and what they want or need during the time of crisis Preplanning can help loves ones avoid having to guess about what the patient needs or wants during their journey It allows all involved to focus on the patient instead of having stop and do the paperwork during a time when they could be enjoying the final days together

Changing the Way We Die ePUB ¼ Changing the  PDF/EPUB
  • Paperback
  • 288 pages
  • Changing the Way We Die
  • Fran Smith
  • English
  • 14 October 2015
  • 9781936740512