November is National Hospice Month; a month in which the nation’s attention should be on the wonderful care and support hospice organizations provide to dying people and their loved ones. Unfortunately, this month we are still reeling from Time magazine’s October 25th article, No One is Coming: Hospice Patients Abandoned at Death’s Door.
I have dedicated my professional life to working in hospice care, to helping people and organizations be their best, and the vast majority of hospices strive every day to do just that. But for those whose experiences of neglect and unanswered phone calls are the basis of the Time article, our track record and good intentions mean nothing.
In response to the piece, the President and CEO of the National Hospice and Palliative Care Organization Edo Banach wrote in part in his letter to the membership, “…The authors cite 3,200 complaints filed with state officials in the past five years. During that period, hospices cared for an estimated 9.4 million patients. Certainly, no bad experience is acceptable, but we should not forget the millions of those who were served well – and the many millions of family caregivers who deeply appreciate the compassion and care they received.”
Tom Koutsoumpas, President and CEO of The National Partnership for Hospice Innovation, wrote in his letter to the editor, “This article paints an appalling picture of hospice care in which care is withheld and no accountability structure is in place to oversee or punish these offending providers."
“Contrary to what is implied in this article, CMS does have the tools to combat this intolerable behavior. Rather than holding hospices accountable for providing substandard care, CMS contractors are fixated on proving a hospice should have known a patient wouldn't die “on time” (within six months).”
Promises made, and promises broken. Good intentions aren’t the same thing as good character, which requires us to keep the promises we make. When a promise is broken, trust is broken with it – and nothing is harder to rebuild. We must be very clear when we promise a dying person and their family hospice care, that we define what that care will be – and follow through with what we’ve pledged to do. Though we may be serving multiple patients and many families, for each of them we’re only given one chance to get it right.
If you are a hospice worker out in the field, working with patients and families in need, don’t make promises you know you and your organization cannot keep. Sometimes there just aren't enough staff to do all the things you know a dying person and their family may need. Don’t put your own license on the line or betray the trust of a dying patient by promising something your company cannot or will not provide. The mission of hospice is to provide refuge, dignity for our patients, and comfort and meaning in their last days of life. That is the pledge we make; both our personal and organizational integrity require us to keep it.