A brief look at the hospice business, death as a business.
|Hello. It's me again with my thoughts and feelings and anxieties. I hope talking about death and dying doesn't make you uncomfortable. If so, you might want to skip this piece of work. Since I've been pronounced as dying, I, understandably I think, have some thoughts about it, perhaps unique thoughts.
I started this piece the week I was introduced to hospice care, in February, 2006. It is now May 1, 2006, and I'm still alive and still thinking about it. :)
My primary doctor is a passive-aggressive kind of guy. I've always suspected it, but I love him for all kinds of reasons and put up with it, as he puts up with me. He once told me that I knew just enough medicine to be dangerous to myself.
I was in his office in early February, and we did our usual song and dance routine, joking and laughing, etc. He gave a few instructions, a bunch of refills and a few sample drugs. He said, "I 'll see you in three months unless you need me."
"Okey dokey," I said.
Two days later, I got a visit from a nurse who said she was there to "assess" me for some services that might help me. A friend of mine who owns an elder care service business felt I should qualify for some kind of help as I was alone, socially isolated and sometimes ill. I explained I didn't usually qualify for benefits as my income and savings have always been a bit too high. She said, well let's check it out, so I said OK, why not?
Two days after that, I got another visit from a nice lady who said that she was a nurse from Beacon of Hope which is a hospice agency. "Hospice, I asked?" Yes, that's what she said. My doctor has said I "qualified" for hospice care which in Blue Cross-Blue Shield lingo means I'll be dead in a year, but I'll have 100% coverage until then. The business of dying has begun. Being qualified for hospice was not one of my life's desires. Know what I mean?
I know I've been quite sick and even thought I was dying a time or two but I didn't really think I was DYING, as in "going home," "meeting Jesus," "crossing Jordan" or in any sense like that. For a few minutes, I could not focus my mind. I felt shaky and my mind raced from memories to poems to the present and back and forth. Eventually, I was able to think straight and listen to the nurse.
The benefits of hospice care can be quite good for the patient. All of my medicines, oxygen equipment, wheel chair and about anything else having to do with disease of the lungs are covered by insurance now, 100% covered, no co-pay. My lung disease is called my hospice diagnosis. I am not covered for diabetes, arthritis or anything else. In addition, there will be care givers, nurses, aides, social workers, chaplains, you name it, all covered 100%. The benefits will save me $200 or thereabouts monthly that I spend out of pocket now. Should a person profit from dying? It's something I thought about. I also thought finally - pay back for 40 years of $250 insurance premiums monthly. There is a God.
All that aside, no matter how helpful, hospice is a business. Before I could say burial or cremation, all my old equipment was gone and equipment from the places they used were installed. I guess it's a "I'll scratch your back if you'll scratch mine" position. Yes, I know that's a cliche. People have been coming and going so much I can't grab my usual afternoon nap which I am sure is hastening my death. The employees have it all down pat. "You don't want to go on a ventilator do you?" I had never thought about it but probably not. "You don't want to die in the hospital being treated as a pin cusion, do you?" Is that what they do, I wondered. When I am dying, will it matter a hell of a whole lot? You should fill out these "Five Wishes" form (advance directives). I read the thing and discovered I have but one desire and that is for my daughter to do whatever she wants after I die. I don't really care. My real wish is that I wasn't dying but that doesn't seem to be an option.
"Your blood pressure is 190/90. You don't want more medicine for that do you?" Actually, yes, I do. I'd rather not stroke out early, you know? That might be a problem. Hospice usually doesn't do anything that will prolong life, at least not for the hospice diagnosis condition. Therefore, I might have a problem with the whole hospice concept, but I'll mull it over. No use rushing it. I might die before I have to decide. :) It does, however, seem to me to be legal euthanasia, a let's kill off the old sick folks who are a burden to society anyway type of approach to age and sickness.
The people who work at Beacon of Hope are wonderful, kind, friendly and dedicated, most of them anyway. I don't think they overly worry about the concept of hospice nearly as much as I do, but, then, I'm the one dying. I wonder if the nurse who sees me every week realizes she is recording my death throes, with my copy of the notes going in my folder? I suppose so. I assume that as conditions worsen they are discussed with the in-house physician, or my own physician. If so, they don't discuss that with me. I'm the recordee. I wonder is there a protocol of sorts. Hmmmm. Let's see, she should be about step seven in the dying process for her hospice diagnosis ... that kind of thing? I don't know.
On that day in February, after everyone left, I was alone again, still a bit shaky but, overll, doing OK. Don't get me wrong. I love company, and can make a duck talk according to my good friend, Vickie. I was just tired and needed to be alone to think and focus. I notified those who I thought cared and then played a bit of Civilization III and had a diet coke. I also had a cookie for I don't think it matters much now if my blood sugar is 180 vs. 200, the cost of one cookie. While I was conquering the world (again) on Civ III, I thought about it all a lot but finally said to myself, what the hey.
Family members and friends have reacted to the "news" in so many ways that it has amazed me, so I don't feel too badly having a few conflicting feelings myself.
My daughter says "That little sh$t doesn't know when you're dying. He's doing this to help you with expenses, and he's also too chicken to discuss it in person." Dr. P is not a big man, but I wouldn't call him that, and he's never been concerned with my pocket book before. I mean $165 for an office visit? :) My daughter, always the cynic. I'm sure she got that from her father. Other than that, she has told me she does not wish to discuss my health or the dying process. She will help in any other way she can, she says, but she can't talk about it.
Kathy, my companion and housekeeper, cried and looked at me as if I were already in my coffin. I wanted to say relax because I don't think it will happen today, but I ended up comforting her.
My neighbor, Bob, said "I wondered why all those people were coming in and out and bringing all that stuff. Do you have to pay for that?" :)
My cousins in WV have all been very supportive and pray a lot. I haven't heard from my brothers, fairly typical. I'm glad that part is over, the notifications I mean. I will name an agent in my advance directives who can be informative from now on. It taxes my nervous system.
Surprisingly, the one who has helped me most as far as grieving is concerned, is the volunteer, Pam. She listens.
When the dust settled, I was still here alone, trying to breathe, piddling around to get the dishes done and the furniture dusted, listening to music, writing my stories, playing my games, watching TV, feeding the birds. The business of dying just won't get in the way of the business of living, as long as I can and with as much pleasure as I can squeeze out. Maybe out of the money saved, I can buy the new Sims 2 expansion pack? And some good shrimp. :)
Until the next time, may we all enjoy living.