I spoke of the road we all must travel on when our life comes to an end…a road of good intentions that at times goes horribly wrong. Telling the story of my mom’s recent passing, I pointed out the quandary in how our loved ones are forced to leave this world…many if not most times with it not being the peaceful death that the movies so love to portray, but instead in agony and pain leaving death as a welcome respite from unbearable suffering for both the one dying and for those left behind who are witness to said suffering. I spoke of ‘Hospice’ and their good intentions, but intentions that can only go so far because they are mired down in religious tenets and secular legalities that turn death at times into the stuff of one’s worst nightmare, instead of it being the bridge to becoming one with God.
At the end of Part 1, I also hinted at the true reason…a reason beyond religious dogma and legalities countless pages long…as to why our civilized society makes the act of dying so hard to take…and it boils down to six simple words…dying in America is big business.
Let’s start with some basic facts about ‘Hospice’…this country’s main organization serving as the bridge between end-of-life care and a hoped for peaceful death. America’s hospice industry has grown over the past decade and a half into a $17 billion a year for-profit industry. This mostly now for-profit industry…an industry that was once the dominion of community and religious organizations…will see almost half of all Americans of retirement age using their services and feeding their coffers before death. And while Medicare and most private insurance companies do cover all if not at least some of hospice care, not all do, leaving the one dying and/or their family to foot the bill for their own death in some cases. And in the for-profit hospices (please know however that there are some not-for-profit hospices still in existence but that their numbers are dwindling rapidly) there is a strong economic incentive to provide less care because they get paid a flat daily fee from Medicare for each of their patients…meaning the fewer services they provide, the higher their profit margin.
A good business practice perhaps, but the stuff of nightmares for those whose services they so desperately need.
And this I can attest to personally for while my mom lay dying in a hospice room at the hospital she was in…we were visited by a for-profit private hospice staff member just once a day with the hospice nurse staying the least amount of time, and with the hospice chaplain staying the longest amount of time. In fact, no one from hospice was there when my mom actually passed away, and it was I, her daughter, who had to pronounce my own mother dead, and it was I who had to go to the nurse’s station to tell them that my mom was gone. Holding my mother’s hand as she slipped away gasping for breath as she tried to say something but couldn’t should not be my last memory of my mother yet it is because this hospice group was spread too thin with not enough staff to attend to all the dying entrusted to their care that day.
Do I blame hospice for what happened at 12:15am on April 8th of this year…no I do not as my mom’s fate was sealed 40+ years ago when she was first diagnosed with Parkinson’s disease, but I do blame the general way our loved ones are forced to travel that road ‘home’…a road mired down in hospital and governmental red tape and legalities that do not allow us to determine the time and mode of our own deaths. My mom knew her time was coming to an end almost a year ago when she said that when the time was right…when she could not take the ravages Parkinson’s placed upon her body any longer…that she would stop taking her 22 pills a day…her choice…her wish…and a few months ago she started doing just that. However, due to the ‘miracles’ of modern medicine, patients like my mom when they are rushed to the hospital are made to suffer in vain attempts to prolong the life they no longer want, because our collective mindset is that we must do everything to postpone death. To postpone death…to postpone becoming one with God…is not only hurting people it is actually slapping God in the face.
The last two weeks of my mother’s life were spent in the hospital where the doctors tried without success to get her to swallow pills she could no longer swallow, as pneumonia and sepsis ate away at what was left of her. And yet as my father, brother, and I all begged the doctors to end this nightmare, their medical intervention by law continued on until finally even the doctors saw they could do no more. And so her last five days on this Earth were spent in hospice care as the bills for her dying grew higher and higher…bills we were covered for but bills which someone in the end has to pay…and that someone as always comes full-circle back to we taxpayers.
And this has nothing to do with hospice care or lack thereof but has everything to do with U.S. hospitals having doubled or even tripled their number of ICU beds, thus spending and charging insurance companies and Medicare an inordinate amount of money on the last hopeless months, weeks, days, or even hours of someone’s life, and the worst thing of all is that this is the kind of care that most people do not want.
So, the bottom line is that…as was in my mother’s case…we are not prolonging life…we are prolonged death and denying the dying their right to be one with God. And why…for the almighty dollar is why and for the right of doctors to say that everything medically possible was done to save your loved one’s life. Remember, it pays to keep dying patients alive and to keep them undergoing treatment, it does not pay to have them die.
“Financial incentives built into the programs that most often serve people with advanced serious illnesses — Medicare and Medicaid — encourage providers to render more services and more intensive services than are necessary or beneficial,” were the findings of Dying in America, a September 2014 report issued by the Institute of Medicine.
Now do not get me wrong as I am a staunch supporter of our medical industry and its quest for quality of life especially for the dying, but I know in my heart when it is time to say ‘no more.’ And while I support both government and private funding for medical research, and I relish in the day when cutting edge stem cell research can be can be made applicable to cure diseases that once were incurable (like Parkinson’s perhaps), I also know that our taxpayer dollars must be wisely spent on the living not on prolonging the life of someone suffering whose sole wish is to be allowed to go ‘home.’
And to that end I must say that sometimes doctors themselves are to blame as our medical system in general has been so corrupted by not only the monstrosity known as ObamaCare but by government regulations and watchful eyes that seem to monitor a doctor’s every decision basing it solely upon the premise of it being cost prohibited. Patients are rushed to the hospital at the drop of a hat not because a hospital is where they should be, but because a hospital stay racks up big dollars and helps to offset the cost of doctor visits, other medical necessities, and high cost standard and experimental treatments.
Just think how much money could be saved vs a hospital stay or an emergency room visit if doctors just made house calls especially when it involves an elderly and sick patient. I firmly believe that each and every practice should have at least one doctor on staff who makes house calls, and that each doctor in a given practice takes turns doing just that…house calls. Not only would hospital admissions and emergency room visits be cut way down, but doctors would then get to see and access their patients in their own homes, which is critical as one advances in age and when one is reaching the end of one’s life. Decisions could then be made by both the doctor and family members who together just might feel that hospital given medical intervention would cause more harm and pain, while knowing that the outcome will be that their loved one is going to die anyway. Letting them die at home or under the auspices of hospice would then become the wise decision.
And while letting someone die with or without medical intervention is not legally the same as assisted suicide, it still would allow for unwanted intervention by family members ill-equipped to spiritually let their loved one go unless it was possible to solicit in writing a person’s preferences for end-of-life care before a life or death crisis occurs. Going beyond the standard legally binding ‘do not resuscitate’ orders that many older people now have in place, an end-of-life document could lay out the specifics of how and when one wants to die and if any medical intervention is wanted or not. Such a document would become legally binding if witnessed and notarized as per each state’s law…that is once laws are put into place and criteria set.
And the critical difference between this type of document and legally assisted suicide…now allowed or being considered in at least seven states…is that no one would have to assist anyone in dying as no one’s hand is needed…the person would just pass at the time of God’s choosing with no intervention by man or machine allowed. This too would separate it from what we call mercy killings. Could the person’s death now be painful and wrought with complications…of course it could…but shouldn’t one be allowed to decide their own fate when there is no hope for recovery…I believe they should be afforded that one last act of dignity…that one last all-important decision.
I know my mother wanted to die a painful and agonizing year before she did…she had had enough as her body was overtaken by Parkinson’s turning her into but a shadow of her former self. I heard her begging to die as more and more tubes and lines were inserted into her now frail and decaying body, and I heard the doctors saying that legally they could not do what they in their hearts knew should be done. And I heard hospice saying the same thing yet at the same time agreeing with me that the hows of death in America must be changed so that the horrors my mother experienced do not have to happen to anyone else.
And that is something God would want for his children…to come to Him peacefully and of sound mind not in the throws of a morphine induced haze, as they leave behind a worn out body to become one with Him for all eternity. My mother was denied a peaceful passing…morphine is not the peaceful panacea most people think…hopefully in time and with the right legislation put into place others will not meet her fate. And to that end I intend to reach out to any and all legislators on both sides of the aisle…after all dying is not a partisan issue…and try to get them to propose and pass legislation that helps the dying pass on their terms not on ours…not on terms laid out by religious dogma and not on terms dictated by government dollars and cents intervention…but on each persons individual terms that serves both them and their families well.
It’s the very least this grieving daughter can do to honor her mother and to help those who come after her in death…a death I pray is more peaceful than the one I just witnessed for like I said in Part 1 of this series, the road to heaven is often, like with the road to hell, paved with good intentions but with good intentions that at times can and do go horribly wrong. But this is a road we can fix and hopefully in time we will as God and medicine need not battle anymore.