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Hospice can also have more practical benefits. "We discuss whether they need a homemaker to wash dishes or read to the patient so his wife can get out because she's exhausted," says Margaret Clausen, president of the California Hospice Foundation. On average, hospice patients receive at least three hours a day more attention than nursing-home patients. And hospice is cheaper than traditional care. For example, at Balm of Gilead Center, a hospice in Birmingham, Ala., the average cost per patient per day is $720, in contrast to $3,180 for ICU patients...

Author: /time Magazine | Title: A Kinder, Gentler Death | 9/18/2000 | See Source »

...hospice, which well-meaning clergy members imported to this country from Britain in the 1970s, ministers to only 17% of dying Americans. "The word hospice has toxic connotations," says Clausen. That's partly because Medicare starts a fatal clock ticking on hospice patients: it will reimburse for hospice only after two doctors certify that a patient has less than six months to live. But many doctors are reluctant to do so, especially for unpredictable diseases like heart failure. Some physicians also fear regulatory scrutiny, since the U.S. Health Care Financing Administration has actually ordered investigations of hospice patients who live...

Author: /time Magazine | Title: A Kinder, Gentler Death | 9/18/2000 | See Source »

...months, after inexplicably lapsing into a coma. Over the years since, he's endured a ruptured appendix; breathing problems; gangrenous feet, which led to the amputation of his left foot in 1998; and seizures too numerous to count. Still, he's been a model patient, giving himself daily insulin shots since he was 10, watching his diet and constantly monitoring his blood sugar. But the severity of his disease continued to make him prone to seizures and life-threatening infections. He never finished his senior year of high school because of health complications, and failing eyesight forced him to stop...

Author: /time Magazine | Title: Five Stories: In Their Last Days On This Earth | 9/18/2000 | See Source »

...Barbara Lane, 53, and suffering from amyotrophic lateral sclerosis, Haven House, a 20-bed residential hospice in North Atlanta, is living up to its name. ALS invariably kills, but the timing is hard to predict, which runs afoul of the hospice requirement that a patient certifiably have no more than six months to live. Coverage can be extended only if deterioration is continuous or if death is predictable within subsequent six-month periods. Doctors determined that they could not certify Lane, after she had spent a year in her original hospice, a third time, but Haven House executive director Metta...

Author: /time Magazine | Title: Five Stories: In Their Last Days On This Earth | 9/18/2000 | See Source »

Just as the title doctor becomes part of a physician's name, so the role becomes part of his identity. Advanced esophageal cancer, diagnosed three years ago, forced oncologist Dan Frimmer to retire at age 58. The cancer doctor had become a cancer patient, but 25 years of medical practice prevented him from viewing himself as anything but a healer. "Of what value am I to people now?" he asked himself after his first round of chemotherapy and radiation, then answered his own question: "I could advise people from a different point of view--from the other side...

Author: /time Magazine | Title: Five Stories: In Their Last Days On This Earth | 9/18/2000 | See Source »

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