My mother was one of the English medical ethicists that helped introduce hospice to the US back in the 50s and 60s. At that time dying patients were not allowed extended visiting hours, full power pain relief drugs and many other things we now take for granted. It took decades for it to be accepted and implemented. Individual units of hospice care that maybe failing their patients are betraying the trust that was the original purpose and hopes of those individuals like my mom. Mom died last week nearly 100 years old and remains a hero to thousands of families in our part of the country.
It was because of hospice my siblings were able to visit my dad during April of 2020. We lost him to covid but my siblings were able to take turns seeing him at a time when other patients couldn't be visited. Your mom helped usher amazing thing to the US.
Because of your Mother, my Dad was given a pamphlet of what he wanted done in the event that he was to die during complications while they gave him his Pacemaker. As terrifying it was to think of losing my Father, I am glad he was asked for what he wanted to happen in the chances of him dying. I thank your Mother for the chance for my Father to have that choice.
Your mom is a hero to me and my family. My grandma passed in hospice earlier this year, and we are grateful that she got what she needed and that we were able to spend as much time with her as possible.
I am so sorry for your loss. Thank you for sharing a bit of her story. Your mother's work helped make a difficult time more humane for generations of people.
I'm a hospice nurse. At the last company I worked for I only did admissions. If the doctor and I decided a patient didn't qualify for hospice based on our assessment, my managers would try to convince us that they actually did qualify so that we could hit our admission goals. I refused to admit a lot of patients that I was told to admit because if I documented what my managers wanted me to say, I could get hit with committing Medicare fraud. It was gross, and we had a lot of patients on service with dementia who were not far enough along in the disease process to qualify. The only way out of this is to make Healthcare a right and not a for-profit industry. The company I work for now is much more responsible about admissions and treats the staff much better than my last company. Hospice is a great service and I love it, but the industry around it is absurd.
I worked for a hospice company in VA. There is no way we would “fudge” our assessment to meet hospice criteria. The only thing I wished was different was people accessing hospice too late. Many thought of it as “giving up”. Every single family I worked with said they wished they had called hospice earlier.
I had a similar issue when I was a hospice nurse. They didn’t tell me to outright lie on the paperwork, but they would twist the existing information into something they could use.
You are absolutely correct. Corporations need to stay the hell out of our healthcare. They will only want to incentivize disease management at very high costs, not cures. Cures don't bring in more money, that is why healthcare needs to be a government service. If government provided our healthcare they would incentivize preventive medicine and actual cures to SAVE money and it would be in the patients best interest. Corporate healthcare is about slashing costs, limiting services, denying non-critical measures. All reasons our healthcare system in America is completely broken. Don't believe the corporate lies either, they have no monetary reason to tell you the truth and monetary reasons are the only thing they care about. The same thing applies to the penal system (we don't want to incentivize crime we want to change behaviors of criminals), but corporations will want to make sure the jail cells are always filled and will rail against any measures to lower crime rates because it hurts profits. Some things should never be in corporate hands; those are just two examples.
I'm currently on hospice with terminal cancer. Treatments stopped working, and after doing multiple clinical trials, my body is just tired. I'm with my second hospice company, and this one is great. My first one wanted to dope me up on morphine and curl up and die. I did what they told me to do, to revoke hospice and go to the ER if I needed it, and then they kindly invited me to not come back on hospice. So I found a new company that I really like. They're wonderful. Even when I did revoke hospice and ended up in the hospital for almost 2 weeks, they were still checking up on me and caring for me. Where the other company basically wanted to just let me die. It's been really nice too, because I'm still young at 51, and they are there to take care of emotional needs of my children who are teenagers and in their early twenties. So I've seen the good and the bad of hospice. It's nice to know that there are people ready to help my family through my transition, as difficult as it will be.
So thankful you found the right one for you. My love to your children, and to you. Unfathomable how difficult it must be, but hoping you are all surrounded by love.
@@rossi5839 I've had several mushroom trips, and they were amazing for me! I would definitely not be as okay as I am if I hadn't had them. They were life-changing.
@@rossi5839I have a customer in a wheelchair with one leg and he is always so happy. Magic mushrooms changed his life he says. He's the most ecstatic person in the room and goes on and on about how great life is and life's so beautiful.
As an EMT in Arizona, I've reported hospice care centers for abuse/neglect more times than I can count. It's at the point where if we get a call to a hospice/care center and it's actually nice with attentive nurses, we're shocked. Hospice, rehabilitation, long term care homes, and assisted living absolutely need more regulations and oversight. We can barely take a box of gloves from a hospital without going through two keycard/keypad doors to a room with 4 cameras in it, there's no excuse for these places which serve our most vulnerable populations to be such a nightmare.
I only spent 4 weeks working in long-term care/rehab facilities while getting my NAC in Washington state. I decided that the 50 cent/hr raise in pay was not worth the added stress, I'd stay with in-home care. And that I'd end my own life before I spent a day in a nursing home as a client. I'm sure there are a few good ones, somewhere, but I'm not willing to see if I can find the needle in the hay stack.
@Kirigiri And, yet--here we are. Republicans would argue for less regulation, but that's not is needed in these situations. Any time there is money involved there are going to be people who take advantage of no oversight.
I very much appreciate the producers of this show making the main stories of each episode available for free to the public. So much great information that gets spread further than if it was locked behind premium cable channel subscription costs.
You make such a good point. Honestly, I grumble at the parts of this show I Can't watch. However, to your point, it is truly a public service that the show makes their meaningful reporting available to anyone who can access TH-cam.
Ads don’t even play on TH-cam during the episodes. The show can lean a little left for me but I love how in depth they go and I eagerly await new episodes.
I'm one of the lucky ones. My mom was in hospice for the last three months of her life. She died of brain and lung cancer at the end of July, and the hospice workers were fantastic through the entire process to make sure that she was comfortable, not in pain, and had everything she needed to keep living for as long as she had left. My heart breaks for all those who have suffered with bad hospice care providers because it really can be such a supportive and essential service.
Sorry for your loss. My mother died July 29th. It’s weird, it was a long process, my mom’s death, it made me believe that it would be easier to grieve. Jesus, was I wrong
I've been a hospice nurse for 20+ years and it's an amazing service. The for profit corps who own most of the agencies now are pure evil and have destroyed something beautiful.
@@tioswift3676 Look for a non-profit company. Not only are they truly out to help the patient but the caregivers usually get paid a little less than other nursing jobs, which means that with there being an open job market for nursing right now, that would be an indication that they truly enjoy doing hospice and are dedicated to what they do.
There is this book I recently finished reading its called The 23 Former Doctor Truths by Lauren Clark, Its full of secrets about modern health industry and my routines started to change so much! I appreciate people like you and these good doctors!
My husband has lung cancer and this couldn’t be more timely. We were actually looking into palliative/hospice care at home. This is very vital information for me. Thank you
@@charlottabrower7968 Please don't let this scare you away from seeking hospice services. The hospice industry is motivated by profits and it's a massive problem, but most hospice workers are genuinely motivated to help their patients above all else. Read reviews of hospice companies and don't be afraid to switch hospices if one does not work out. I'm sorry about your husband's diagnosis, cancer is the worst.
My mother is currently in hospice care at home. I will tell you now, it will be rough. And do everything you can to make sure that every single helper is on the same page as things draw closer to the inevitable. But also there is one thing that this week has done, and it has given me the chance to tell her how much I love her, to say all the things I didn't get to say to my dad when he passed, to let her know what she means to me and how I'll be okay. It helped me come to terms with what will be a huge change in my life and let her know what I plan to do to move forward. It has shown me all the good people in my life who have come out of every circle of friends to offer care and support. And most of all, it has given me the chance to say goodbye. I've done all I can. It's just keeping her as comfortable as possible and waiting at the shore for the ship to come in and take her to where she'll be for her next phase of existence. My heart goes out to the two of you, and if you believe in any kind of faith, I hope that the divine presence smiles down upon you both with peace and compassion.
i’m a hospice nurse AND my mother just passed in hospice. You definitely have to be careful (as with anything) but please remember hospice can be immeasurably helpful. But I would NEVER work for or use a for-profit hospice
That is the big point I think this show missed entirely - the non-profit hospices are generally wonderful, the for-profits are the ones to avoid. How did they miss that?
From my understanding $999 million was the total revenue and only part of that was due to a scam. Often with these things the issue is to proof in court every dollar of scam...
I was a hospice chaplain. Was once called by the corporate overlords because I spent 90 minutes with a patient. I got chewed out because Medicare only covered 30 minute visits with the chaplain. They were more concerned about the billing than they were the patient's care.
Also, we had a doctor on staff but he only came on Thursdays to our meetings and signed off on nurses notes. Never once visiting patients in home, at least while I worked there. I even asked my boss, hey does dr. Go visit patients and she laughed. He did bring in bagels each week, which was nice.
@@jayfabethat's horrible. How can he call himself a doctor ..can you imagine a mechanic coming in and looking at notes about cars? Or a plumber, and you getting paid to minister to people is shocking to me. Who gets that your church overlords? The Vatican or do they pay you directly? Per half hour? I dont even comprehend that.
@@nataliaalfonso2662 no... they get paid a stipend by the church for their living and what they do within the week whether they spend 59 hours with a dying person or spend all day eating buns they get paid the same living stipend ... not paid for every 30 mins ..Jesus mary and Joseph what have you done to the church in america? You've turned it into some sort of capitalist venture for profit? Disgusting.
Both my parents died at home with me and hospice. Experience with mom was phenomenal. I don’t know how we could have done it without them. My dad was a vet and we went with hospice his dr recommended. It was horrible. Had to do intake twice, nurses just didn’t show up, and didn’t care. I called the regional executive director. She basically said “yes, and….?” If you have hospice you can change at any time . An employee of the crappy company told me this and said this was regular business for them. We went back to company who cared for my mom and had another exemplary experience. Switch if you are not satisfied!
Thank you so much for covering this topic. Growing old in America is pretty horrific, particularly, poor elderly. More needs to be done for the elderly/disabled.
At age 78, my father went to hospice for terminal cancer. He was one of the lucky ones in that he wasn’t suffering with much pain. A few weeks in, I spent a week in the hospice with him, same room, and noticed that they kept him doped up pretty good. Just as soon as he would start to come out of it, they would dope him again. I questioned them strongly on the amount of meds given he wasn’t in much pain. With the reduction in meds, he was his old self again so I took him home toMom. They had had a very happy 58 year marriage. They were able to spend the next 5 1/2 weeks doing what they loved best, which was just living a quiet home life. After that time, there was no denying that it was time for him to pass. We took him back to hospice and he died in his sleep a few hours later. I always say that we need someone with us 24/7, in effect to guard us during our most vulnerable time ever during hospital stays. Question authority. -Albert Einstein
I am an admission nurse for a non-profit hospice. I would never work for a profit-based hospice as I find the idea of making a profit on people’s deaths as reprehensible. I see the marketers for profit-based hospices in nursing homes and hospitals, chatting up clinicians and administrators, I see the gift baskets in the case manager and social workers offices, all from hospices that are trying to make a profit. I’ve spoken to other hospice professionals who have quit those hospices because the business model is to have admission nurses work on a commission-only basis, fueling the practices and scheming that John talks about here. Hospices should NEVER be allowed to exist as profit-based companies.
TO reply, the non profits especialyl in SW Ohio here have become these profit driven machines. They convince families they need IPU care when in fact, they could be at home on CRisis CAre. HOwever, that doesn't pay enough so families rip up their lives to go watch their family die in a sterile building. The smaller for profits are not all money grubbing, some of us made an alternative to that uncaring nonprofit to give better care, and that is why we excel and provide unpaid services like Bedside PResence in the last 72 hours of life regardless of medical need.
People have always profited of other people's death. We have a saying "One man's death is another man's bread". It's not the profit part that is the disturbing part, but the complete lack of ethics in jacking up those profits. As a worker you want to be compensated for the work you do. As an investor you want to be compensated for the investment you make and the risk you take on that investment. People working on a commission-only bases is dubious at best. It delegates the risk of doing business to workers. That risk is why profit goes to investors. That is their compensation for the risk they take. Workers need to be compensated for the hours they work. Remove the incentives for workers to engage with unethical practices.
Hospice made my mother's last days beautiful. They helped move her in to my home, had someone stay with her and I while my dad rested, made sure all her needs were taken care of with me so she could die with the dignity she deserved surrounded by family. Thank you hospice, and I devoutly hope more people can get access to the kindness and respect for life my family had from hospice services.
My friend entered Hospice after spending almost a decade fighting cancer. When she went into to hospice, she passed three days later. She was only 30yrs old and was such a kind and generous person. i think that when she entered hospice, she realized she could finally rest.
@@ytgytgywell it may be true cuz everyone that I know that's ever been in hospice has died pretty soon they always put people on liquid morphine and some type of benzodiazepine which we all know causes respiratory depression which is where you stop breathing and die
My grandpa is on hospice now. He's been suffering for so long with chronic wounds that have led to a leg amputation, diabetes, paraplegic, and CHF. I'm so glad that he has this option and is at home surrounded by family and getting the support he needs
Yes! Hospice music therapist here! Yeah, all of this is so accurate. The live discharge rate of the hospice I work for is heavily scrutinized by our business daddy. And we do occasionally get patients who stay on hospice for a year or two, but the nurses have to show that these patients are steadily declining in order to keep them on service. Some people just decline very slowly. But five years?! That’s an insanely long time to be on hospice. I think the most I’ve ever seen is three. I feel terrible for anyone who got scammed by these hospices, particularly the people who didn’t receive services. Shame on anyone who takes advantage of a dying person.
wow so they do exist? we were told so much when mom went on hospice. been over a year (dementia). can count on one hand the chaplain visits and then 2 haircuts. no art, music, walks, companions, visits... they charge medicare a fortune yet all these services they can't provide? but thank you for doing what you do. I know you touch people and make such a huge difference in patient and caregiver lives.
@@domino427family Oh no, that's so sad. So sorry your mom was deprived of the services she deserved. Yes, my hospice provides massage therapy, music therapy, social work, chaplain, bereavement, volunteer (companionship), and nurse/aide services. Through these comments, I'm beginning to really feel the huge discrepancy between the hospice services and quality in my area in Iowa versus other areas of the country. It's quite tragic 😢
I have a few patients who have been on for 3-5 years. Many of them are over 100 and/or extremely underweight. It’s very obvious their body is deteriorating. They are just declining sooooo slowly. Hospice does not (should not) kill people. So we follow what the person’s body is showing us. How could we discharge someone who is 80 lbs and 105 years old? We’d be monsters. We jokingly say those people are “suffering from good care”. That’s the sign of a good facility that is keeping these people alive and following their body, not doping them up or leaving them in dirty diapers.
@@domino427familywe used to have music art and massage therapists with our hospice company. They got let go because of budgeting. The rest of our team is still so upset by it. The expressive therapists are incredible on hospice. Especially for those who are so lonely and isolated. Thank you for what you do.
My mother was on hospice for her last few weeks of life. First day, we gave instructions to the night nurse to make sure she got her meds at the right time, and the nurse slept through the night on our couch and did nothing. My mom went nonverbal after that, which was unfortunately before all her kids could make it down to say goodbye. I'm not saying that my mother would have made a miraculous recovery, but the fact that someone who was being paid to watch after my mom failed to do so is insane. My father is still in a legal battle with the hospice company to try to recoup some of the costs for the down payment they had to make for their negligence. It's incredibly frustrating, especially since he is still grieving.
Thank you for this episode. My grandfather just passed with us and hospice providing care. I'm so infinitely thankful for those nurses. I'm also thankful for life, the timing of bringing me my favorite show with the most appropriately timed episode. Thanks John you've touched mine and probably countless others lives, never stop covering these hard topics. There will always be people dealing with these hard truths. Thanks for 10 years of amazing work.
I am an atheist. I don't believe in the existence of God. There is insufficient evidence or rational justification to support the belief in any gods or supernatural entities. I rely on reason, logic, and empirical evidence to form my worldview and do not find compelling evidence or arguments to support the existence of god.The universe is governed by natural laws and forces, rather than moral, spiritual, or supernatural ones. As an atheist, I reject the idea of God. I emphasize the social and empirical nature of inquiry and prioritize scientific solutions to intellectual problems. There is an intrinsic intellectual conflict between faith and science, and that it inevitably leads to hostility.
@@snehashispanda4808dude wtf. The guy’s talking about his recently-deceased grandfather and you decide that now is the time to go on an anti-religion diatribe?
My grandmother had it in 2010. She actually lasted longer than any other in their system. The nurses who came to my Mom’s were kind and thorough. Not only did they do the medical things, they helped Mom psychologically get through it. I would hope that everyone could have had that level of support.
My husband is in hospice now and we don’t get any support. We had an incident just yesterday morning and I called them and I got a recording. I left a message for someone to call me as soon as possible and no one ever returned the call. I wish I knew a better company to provide this because the one we are using is horrible.
Many providers, especially outside of USA, are pretty decent. Even within USA there are a lot that are fine, but their system allows for too much grift or outright fraud.
That hasn’t been the experience of the last 3 people I’ve known. Pretty evil whenever they’re pushing hospice onto a lady who’s still well enough to attend public functions & wasn’t exactly wasting away. And then my bf had the sweetest lil aunt, who probably had another good 3 years, and they (& her son) were insisting that she needed medication, when she was being very verbal about not being ready. She was gone within 2 months with their help, & her son had blown through his inheritance within 3 months. Makes me grateful that I’m estranged from family.
Hospice Nurses are some of the sweetest, most caring people in the Healthcare industry. When my Grandpa was dying, he chose to be at home, and his hospice nurse was the absolute best! She took amazing care of him in his last days, and explained the "death process" to us because some strange things can happen and she put us at ease. When he did pass, she cleaned & dressed him in his chosen burial outfit and that was a pair of sweatpants & his "Monona Home Talent" baseball sweatshirt which my uncle's play for and he was the coach of for a while because he wanted to be comfortable for his eternal nap... ❤ He passed 15 years ago today... RIP Bumpa
@@thehegemon996 what's fake? hospices? they exist, so not that. what's fake? all my losses that hospice has helped me through? if that's what you meant... *losing my parents and my husband is "fake", you jackass?* my grief is fake? that's good to know. I should just get over it then, should I. right.
I am genuinely glad for your family if you found a company to actually care; our local hospice stuffed my grandfather into a small room with another man, and fed them pb and j sandwiches twice a day everyday (but its okay because on Fridays he can have a dry chicken sandwich). Checked on them 1-3 times a day. Let him rot for 2 and a half years while milking him as much as they could the entire time. Not the employees fault, but it's definitely a shit industry through and through. There is no chance in fucking hell - which thankfully doesn't exist - that I let my parents die in this country. (Fun Depressing Fact: The other man in the room with my grandfather, had been in hospice for 13 years after suffering a stroke. He was completely there mentally, miserable, just unable to walk around on his own. They cut corners and lifted him without the proper equipment, and dropped him. Breaking his hip. Leading to his death a few weeks later. It was a really great time to hear an aging grown man crying on a daily basis when I went to visit. Listening to a man sob about how the nurses killed him by dropping him; knowing full well that people his age don't recover from injuries like that - was extremely rough and I don't think I'll ever forget those nights.)
My own father and brother have been under the care of our local hospice in Ireland. My father died peacefully last week and we couldn't be more grateful to the caring and understanding hospice staff ❤❤
Not to be a buzz kill, but Hospice Nurse Julie is seriously great. My 84 year old mom had a major stroke last year and requires 24/7 care, and her channel has provided me with so much invaluable information as to what to expect going forward.
You're not a buzzkill at all! You're sharing good information. I'm glad you were able to find some comfort (on TikTok, of all places!) in a really tough time. Sending good vibes your way.
I am so very glad you posted this. Hospice Nurse Julie helps her subscribers understand the processes of death and her compassion for her patients is palpable. I felt betrayed, actually, when I saw her being made a butt of jokes on this program.
I used to work for a wonderful nonprofit hospice. The staff, Medical director was a wonderful caring MD. When I started there it was the first time I felt like a "real RN" after years of working ICU. It was wonderful place to work. I was allowed to spend as much time needed to give good care. Then one day the board hired an administrator from a for profit Hospice. The changes the administrator implemented was what Hospice was supposed to be trolling ER, Skill Nursing facilities etc for potential clients. There should be no profit for caring for the dying. I quit and I was so disillusion in nursing that I quit nursing altogether. Hospice can be a good service to help they dying pt and their family and should not be used to make a profit.
I am a hospice nurse and I’m in a very similar boat right now. Doing hospice makes me feel like a “real RN” and I’m truly helping people, just in a different way. I love what I do and caring for my patients. You meet so many people with very interesting lives and customs and cultures, and it’s amazing. But we’re kind of in the same boat, hiring administrators who’ve never touched a patient in their lives making the decisions. It makes the work not enjoyable anymore because we’re always worrying about money and budgets, not the humanity and care for people at the end of their lives. I’m actually at the point in which I’ve considered quitting hospice, which breaks my heart. I have a second job in a different area of medicine to fall back on that I also enjoy, but I feel like I’d be betraying my patients if I left hospice. I know their care and experience doesn’t solely depend on me, but I advocate hard for my patients and work tirelessly to ensure they’re happy and comfortable, and that their loved ones can feel relief knowing their loved one was comfortable and peaceful. ❤
Our hospital here in Asheville was wonderful, with a state of the art cancer center & a national reputation. Then it got bought by a big corporation & all the oncologists quit, the nurses have gone on strike, the state Medicaid office put them on probation, & the county is calling on them to sell out to a more reputable company. It’s so upsetting.
I am a retired, disabled RN, who worked at our local free-standing Home Health and Hospice in the 1990's. I worked in the trenches, so to speak...after losing my father to a drunk driver during that time, I was forced to move away from my beloved role. I then worked for a local HMO clinic for 13 years. That was wild in it's own way, mostly due to the takeover of corporate medicine, big pharma, etc. I've seen a lot in my day. I was wondering how you could spin something like Hospice, which is still a sacred practice to me, but we no longer even have our wonderful community hospice, which saddens me. Seeing all of these unconscionable stories on this show, gives me another round of soap for my soap box on the corporate medicine, big pharma, and the oligarchy robbing us blind, yet also the show provided the best medicine for whatever ails you--laughter!! The Matt Gaetz comment...classic!!
I haven’t watched this episode yet. My mother’s funeral was a week ago today. She was on hospice. I can’t tell you how many times a day I see something that smacks me in my face with a handful of grief. It’s everywhere and it fucking hurts. Spend time with your loved ones.
Ik it’s probably the LAST thing that you want to hear right now, but that horrible blow does soften with time. Some days are tough, some are horrible, and there are some good ones thrown in there, too. I lost my mother unexpectedly last fall, and the first sleepless nights it felt like my heart was in a vice, actual physical pain. But it WILL get better. Remember her, especially the funny moments, and talk to those you can trust. Love and light to you and your family ❤
@@casualeann I appreciate you. I know it’ll get better, and I know the sudden tears are necessary. I’m not one to run from emotion, I cry tears of happiness for strangers I hardly know. I hate seeing my kids so upset, but it’s helped me realize that life is temporary and I need to do everything possible to live a long life for them.
When my grandmother died in the 80's, I remember my Mother saying "Hospice is a wonderful organization. They come in and take over and they take care of everything." It's so sad that something so wonderful can become so corrupted by greed and malice.
I’ve sat by the side of four family members going through hospice. Luckily they were all at the same hospice house, and they were treated very well and had a peaceful transition. Hospice is a great thing, letting people be comfortable in the time they have left is the least we can do.
My grandmother just passed away last month in hospice care after she had a stroke during heart surgery. She lived very far away so we could not be there when she passed, but the nurse that let us know she died said that she sang to her 10 minutes before she left us, and I will always be so thankful for that wonderful woman. I'm also grateful that she only suffered for a month before passing, I'm definitely one of the lucky ones.
nice work 😎 brutally accurate there are 4 ways to make money in hospice 1 aggressive sales 2 relentless cost cutting 3 financial engineering (M&A) 4 fraud
I'm a hospice healthcare worker and have been for over a decade. Ty for this absolutely spot on assessments here. I went from facilities of various specialties(memory care, assisted living/apartments ect). I stayed at homecare because its really where hospice should be but I realize that is not accessible to everyone which is sad none the less. End of life care is so important to have better oversight going on, there is absolutely no reason these events and horrid tragedies should happen. Greed is why 100%. I absolutely loved every single person and family I ever cared for. CMS and many many hands in these pots need to be held accountable. Families deserve to be made whole period.
@NathanSimonGottemer "existential crisis day" used to be sometime Monday morning, after a full "bender" weekend that usually started Friday night... Moving it to Thursday only fuels the need for a long weekend...
The best way to get over existential dread is to embrace the fear. Go volunteer some hours at a hospice. There are numerous roles but the best and hardest is social visits to those dying without family or friends remaining. Seeing the dignity and grace of a “good death” and exploring beliefs about dying with those going through it is almost 100% guaranteed to move you towards acceptance and away from fear of the unknown.
I saw home hospice care with my dad last year - he did not have a good situation, due to his denial that he needed care for a long time, and my mother’s resentment of these “strangers” coming in to do something that she denied that she was incapable of handling herself. I mean, it got very bad. i tried so hard to get him better care that I ended up getting totally disowned by my parents. At least I got to tell him I loved him before it got to the worst point. But I missed his memorial service, and my mom and I have not spoken since then.
Hospital or nursing home? I think the big problem are nursing homes and at-home PCA care as our father also received incredible hospice care while still in the hospital but dreaded the idea of needing to transfer to nursing
I was a hospice aid for several years and death was nothing to me...til one of my patients died from a sudden heart attack in my arms 😢 it takes such a strong heart to take care of others in their final days and i wish i could still keep doing that, because i loved my job and the people i took care of.
My father in law just passed away last week and was in hospice care, I am extremely grateful we had honest care and I saw first hand how much they truly cared for his pain and humility I am sorry to those who got treated like this. Shame on them
We were victims of hospice fraud. Kickbacks to the board & care administrator. My mom suffered horribly because of it. Blows my mind that people can act this way, knowing they are causing untold horror. They should never be let out of jail.
I am so sorry you went through that. It is beyond the pale to deal with grief and full time care. I still feel guilty. I just didn't know. Now the most important person I'm my life is gone.
My dad works in hospice care here in Germany. When I heard that 2/3s (?) of hospice companies in the US were for-profit, I knew what the problem was ... but even then I couldn't imagine things being that insane. Healthcare (including hospice care) is not something that should be run as a business.
I mean tbf something being not for profit in the us doesn't necessarily mean it's any better than a for profit, just that by the end of the year they have no money left over after paying the higher ups salaries
I could not be more appreciative for the hospice care my wife got during her last two months. It was fantastic and made all the difference. That people would rip off dying patients is ghoulish.
My grandfather, who wanted to die at home, received hospice care after his terminal cancer diagnosis. They were absolute Lifesavers and couldn't have been more kind or empathetic. Thank you to all the good ones out there
For a brief second there, I thought you were going to say Reagan did one thing during his presidency to alleviate suffering (approving hospice). I was bewildered and had an existential crisis. Seconds later, you saved me from spiraling by reaffirming that Reagan was indeed one of the worst humans in modern history because his rationale for approving hospice was to save money on treating people. Now, that is the Reagan I know and hate!
Reagan has really been underappreciated for the level of criminality in his administration and the venality of his policies. Hard to name any other president besides Trump who despised the poor and working class more.
I will always remember the kindness and warmth my family was shown in hospice as my dad passed from cancer in his final two weeks. I found comfort at such a traumatic time in my life at only 14. There was even a group of volunteers at the hospice who sewed a pillow out of my dad's shirts for me. I will be forever grateful for what these people do
I volunteered for Hospice for years. I assisted clients and their families through the toughest and scariest times of their lives. I made a great many friends that I knew I was not going to get much time with. It was simply one of the most rewarding and painful experiences of my life, and I wouldn't trade it for anything. Great story: a dementia client of mine that almost no one even in her care facility could understand anymore trusted me so much more than her care staff that she wouldn't let them take her blood pressure without me there. She told me we should go out with her husband (who had been dead for years) for drinks. She trusted me because I sat with her, and listened, and lived in her world with her. Her family, and so many other families, contacted me on their deaths to thank me for my time and effort. Obviously not why I did it, but it made me cry every time.
Why are people complaining? Isn't this the world the Boomers wanted for us? Everything privatized? I wonder what the stock price of these "Hospice" facilities are? 🤑
My grandfather who passed away back in May was a big volunteer for hospice. Helped raise $4million in southern Maryland and even helped build a hospice facility. He received in home hospice care for the last week of his life. Full circle. We all miss him.
Wow. Thanks for sharing. It sounds like he was an amazing person. What hospice did he help build? It must be one of the few good ones considering his history and work.
@@DaveHurka I don’t know off the top Of my head. I remember visiting it as a kid though. It’s one of those things I was too young to know what was going on and it never got brought up until he passed away. He received the Presidential Volunteer Service Award
Thank you for this. Our hospice experience was traumatizing for me and my family. My dad was in pain and my mom was left alone to figure out his care. The amount of fighting I had to do for my dad on his last days to die with dignity left me with nightmares for months
this was also our family’s experience. i know so many who had wonderful experiences and i am so bitter that my loved one suffered so much. we had to spend so much time fighting when we should have been spending the last moments with her.
I was pleased that hospice treated my grandmother with the dignity she deserved- they changed her clothes twice a day, had aromatherapy, morphine, and kicked me out of her room: "please step out, we need to change her clothes". I thought they did well for her comfort and treated her with dignity. We might have been lucky; thankfully.
@@philipreeves9311 Color me unimpressed by Cheney or his spawn. Cheney, Rove and Bush walked so Trump supporters could rush and beat police while attempting coup. There'd have been no Trump if not for Bush lowering the bar so much, and Cheney was gleefully along for the ride.
I've worked in Hospice for 21 years. There has been fraud like this since 2010 when the rules changed, and many 'independent' hospice companies suddenly popped up. The fraud has impacted us being able to deliver services like caregiver relief, and other services families depended on. The for profit companies like Vitas and others have made it much harder to provide good care to people. This is the minefield we navigate now to provide end of life care.
My Dad has been on hospice since may of 2020. I pulled him from a nursing home at the start of the pandemic. He was given 2 weeks to live. Tonight we watched the Bachelorette together. Being put on hospice actually saved his life.
@@merkinidgit Mostly grief. I wasn't ready to accept she was that close to death. Also my view of hospice was they go away and sit in a room hopped up on morphine for the last month of their life.
Home visits are worth it but you pretty much have to “childproof the room” and make it very safe. But I’ve known children of the elderly who let themselves burnout and got frustrated and exhausted with their parents that could be as bad if not worse than the worst hospice places out there.
@@jonn.5568 They don't offer in home care, we had to hire someone to give her showers. This is a nurse who comes, checks her vitals, listens to her concerns, and prescribes medications. But it meant we didn't have to leave and go to the doctors anymore, which was becoming impossible. She wasn't able to handle car rides getting in and out of a wheelchair and sitting in it for an hour, and we couldn't handle constantly taking off work to take her to appointments.
So, my mom died of cancer in 1996. About a month before she died, when we expressed how hard it was getting to care for her personal needs. Her oncologist suggested hospice, but he made a full disclosure that he and other oncologists owned the hospice. They got us the equipment we needed (bed rails, bedside commode, etc.). A certified nursing assistant came for 8 hours a day. She showed me how to move mom to minimize her pain. A registered nurse came twice a week to assess mom's pain, and to change medications as needed. She came out to declare Mom dead (dad and I had been with her when she died). I don't know what they charged the insurance company, but it was a lifesaver for me and dad. Dad wasn't physically able to do much. I was working full-time, and I would sleep next to mom's bed when the CNA wasn't there. They made a different time more bearable.
Okay, huge cheat code for everyone. Contact your local funeral directors, ask them who their favorite Hospice care personel are. They will tell you which ones are the most present, helpful for families, and concerned with actual patient welfare. Also, because of the nature of their work, they will also only recommend Hospices which work with patients who are actually dying.
My dad spent a month with hospice back in April and we can’t say enough of how well they took care of him. We know we were blessed with a hospice nurse who fought hard to keep him comfortable. My heart breaks for those who didn’t have an advocate like we did.
Thank goodness for hospice nurses. My father had terminal anxiety and could not find rest, the hospice nurses where able to give him full strength opiod drugs to let him relax finally and he passed in less then 24 hours. He was so peaceful. the most peaaceful he had been in months. Dementia and alzhimers is a terrible disease and to see my father suffer was terrible but to finally have my mother get peace and see him in peace was all we could ask for. he was so worried. RIP Dad. I will always love you and miss you 8/6/2024.
As an oncologist this is surprising to me. I do send patients to hospice, when we have run out of any beneficial treatment. In my 10 years of work, i never had a patient who came alive from a hospice. A live discharge rate of 50 percent. Wow
Some pts may go into hospice temporarily, for short-term on-site respite care if they have been under medical care at home. Caregivers need a "sanity break" away from the stress of looking after a terminal patient constantly.
I'm so grateful my family had a positive experience with hospice care when my father passed. I can't imagine how awful it must be for these families who were neglected or taken advantage of. A death in the family should never be treated so flippantly. This is another example of why for-profit healthcare is a conflict of interest.
Both my parents received hospice support. My dad at home in the last 6 months of his life and my mom in an inpatient hospice unit. Both were incredibly helpful to them and to the entire family. Not sure how we would have managed without it.
Health care should never be subject to the free market, just like schools, streets, railroads, prisons, police, water supply and other basic needs. And as long as those needs aren't met, nobody should be allowed to own billions of dollars.
Medical services so obviously lack the necessary conditions to able to operate as a market that those who push for it to be treated as one are either clueless or they have their own greedy hands in it. Probably both in many cases.
I work for a non profit hospice. Not all of them are corrupt, for sure, but we often get called in when families fire another shitty hospice. The money first mentality is pretty shocking.
Amen! One of my biggest pet peeves as a non-profit hospice RN of 25 yrs. For-profit hospice will often dump them in the ER when their care starts to be difficult or expensive after milking their insurance for months/years, and then our ER winds up calling our nonprofit hospice to pick up the pieces.
I’ve worked in hospice in Washington state. I think some states have scammier hospices than other states. these scammy hospices are unrecognizable to me. I worked in hospice 3 years and never saw anyone on “continuous home care”. The most important thing to know about hospice is it usually consists of care in the home provided by family members with some nurse visits for management of medications - inpatient care is only for management of out of control symptoms. It is true that you lose access to curative treatments when you enroll in hospice, but you can ALWAYS choose to revoke if you change your mind and want to pursue treatment.
My mom spent a few years trying to get a diagnosis here in the States, but they just told her it was all in her head. She moved back to the UK to where they diagnosed her with ALS and provided her amazing healthcare, hospice care, and allowances to friends & family who took care of here at home. It was a comforting and humbling experience to see the kind of care they provided. She only lived for 3 more months, but she was with those she loved and was in her homeland. In the States, they would've snatched every dollar from her frail fingers.
Weird how putting excess amounts of money and profits without regulation creates corruption. Or as we in The United States call it, our entire economy.
As someone who was born and raised in a hospice, I really appreciate you covering this topic. Seeing those two old coots tantalizingly feed each other sliced vegetables really brought back some wholesome childhood memories. Thanks!
One thing that John did not mention is that hospices are required to evaluate patients at admission and at regular intervals while on hospice to recertify that they remain hospice-appropriate. Due to the variety of disease processes, responses to care, and frankly will to live or die, it can be very tricky to determine the timing of someone's decline and death. Hospice companies have to be willing to not only fudge the admission, but also ignore (or just not conduct) their own regular assessments in order to put/keep people on hospice without cause. As someone who works in hospice, there are caregivers doing selfless and compassionate care in this space. And it's not as of people are lining up to spend time with, much less care for the varied and complex needs of, older and terminally ill people in America.
There's a lot missing in defining Hospice in this episode. For sure there's corruption where ever money can be made, but to the unknowing mind this episode can define what most hospices are and the extreme patient care and dedication each one gives to dying people. How about a lot of the patients are abandoned by their families thats one cause for long term patient care, or a lot of hospices are severely under funded or under staffed. Again, more needs to be said to defend this practice to not convolute people's mentality about Hospice.
If you're running the hospice correctly then this piece isn't about you. It is important to put a bad hospice on blast or it becomes the norm like bad nursing homes are the norm.
Yeah, I think John Oliver should have spent more time on how horrible it is to WORK FOR hospice rather than hospice treatment. A lot of folks have great experiences with hospice, even though there are areas and hospices that give horrible treatment. HOWEVER, the actual issues are recertification, treatment and pay of staff, and how care is rapidly deteriorating while being propped up by staff who are literally working themselves to death to shield patients and their loved ones from that decline. We unfortunately have come a long way from Saunders and Kubler-Ross in this day and age of the suffocating cancer that is corporate America.
I worked for a hospice as a bereavement coordinator for 2 years. Our non profit hospice was bought out by a for profit hospice called Gentiva (owned by a venture capital firm). They implemented a bureaucratic system of management and made small frustrating changes to operations. In the following year a lot of dedicated workers got frustrated and left. Many who didn’t leave were laid off.
This is the sad reality of many health-care facilities/ organizations. Mental health facilities are especially ripe for the picking by venture capitalist. What kind of monster preys on those in need of medical services.
Gentiva is one of the worst but there are so many hospices under venture capital firms. There are people who start up hospices, throw a ton of assisted living people on their census by bribing the administrators and then sell. It’s truly a hot mess right now.
My mom was placed into hospice in 1995. I was 14 so I didn’t really understand what that meant at the time. My dad took me to see her and she looked pretty messed up, but I thought she was gonna pull through. Ended up dying later on that night. That is a crazy place to work at. I don’t know how people do it.
@@sidvicious332No it's a special calling for medical professionals strong enough to handle it physically and mentally. Not "just another job that sucks"
My dad is literally dying of colon cancer right now as I type this, hospice is denying him care!!! This opened my eyes and made me realize I have to fight for him!!! Thank you for making this episode.
One of the things hospice does is stop any medications not providing immediate comfort/quality of life, while ensuring relief from pain. I’ve heard some people, relieved of drug burden and now comfortable, show quick improvement and love much longer than expected! ❤
I almost came to blows with my father's hospice nurse. He was sending lab techs to my parents' home to do his job. When I found out, it was go time. He lost his job.
I provided pediatric hospice care when I lived in the states. My father had home hospice for 5 months. We were very fortunate to have wonderful care givers and nurses.
@@MadPunky it was difficult, but I loved supporting the families and kiddos. I did it for only a couple of years. I’m still in touch with 2 families. I have a box of wonderful letters from the families.
@@AlzheimersCaretaker I salute you and your dedication very admirable. Though it is a sad state of affairs when you can't trust your care facilities...
I'm in Canada. We tried at-home care for my grandpa the first week he was diagnosed with terminal cancer, and it was very difficult because we could not provide the level of round-the-clock care he needed. Finally, we transferred him to a hospice facility, which cost some out-of-pocket money but was still part of our provincial healthcare system, so definitely up to the standards of a hospital. I t was so much better after that. The staff were experienced and so caring; he had family staying with him all day and night, the level of care was above and beyond what we could give him, and the burden of taking care of him was lifted from my mother. He only lived another week after being in hospice. I wish we had put him in the hospice right out of the hospital. I think he would have lived longer, and his death would have been a lot less painful for him and traumatic for my family. I hope someday you in the US get a health care system that doesn't treat patients like products on a factory line, and I'm so sorry for any American who is left to avail themselves of the profoundly broken system.
Thanks for this John. My father was in hospice his last year of life, at home during the pandemic (he had terminal dementia). Throughout his hospice care, his dementia symptoms were "treated". He didn't need pain abatement until the last month or so. He was under very good hospice care at their facility for about 2 weeks, while I was away (I was his primary caregiver), during which, he got excellent care at the hospice facility. But, The hospice, a non-profit, could only keep him 2 weeks, then he had to go to a nursing home of my choice under a Medicaid program for another 4 weeks. From day 1, he received sub-standard care ( he fell out of bed and was injured the second night because they changed his medication). When I was able to bring him home again, it was a struggle to get his appropriate meds ramped up, but still it was a steady slide into death. I desperately needed that break after almost 3 years in my care. But, his close to final weeks were needlessly terrible - NOT because of hospice. The hospice care in nursing homes is all about minimal care, and profits for the private owners. I could go on.
My Father-In-Law died from cancer on Hospice. It was horrible. He was seen minimally, but they did not work with my Mother-In-Law at all about what was happening or what to expect. They dropped off a brochure and a little book and that was it. He laid in his own urine for days because we could not physically change the pads that they said we should be able to without their help. He died horribly and it haunts all of us still. I interned at Hospice 20 yes ago. I know it wasn't supposed to look like that. Later, we were told it depends on the nurse you get. Some are really good, some don't care...clearly, we got a team that just did not care. I have no idea how much money they charged, but even free was too much. All they did was make sure he had a hospital bed and meds. All the people defending the hospice nurses...I do hear you and yes, clearly there are good nursing staff out there. But that doesn't make the crappy stories and the fraud less true.
I like to volunteer at my local hospice center to help out when I can, I really am happy to see the different activities that this one provides. It has an outside area for gardening, which can be used to help patients relax and remember loved ones. It provides cooking and baking activities that can help the seniors reminisce and stimulate all five of their senses, and it has a television lounge where they can watch the recordings of nineteen ninety eight when the undertaker threw mankind off hell in a cell and plummeted sixteen feet through an announcers table.
I feel ya man, my grandfather just passed away a couple of days ago from multiple organ failure. I never met anyone on my father's side of the family, so with my grandmother passing in 2019 and my grandfather passing a couple of days ago I no longer have any grandparents left.
I used to work at a hospital that had a dedicated palliative care unit, with nurses familiar with all aspects. Families gave each other moral support, and helped provide comfort to each other whenever a patient died. Nurses were always available, and they coped well because of the ongoing support group environment. A new hospital administration disbanded the unit, because it "raised mortality statistics" and instead, dispersed terminal patients to other specialty units, with regular nursing staff, and listed them with the local hospice. Coping and mutual support were gone. It was harder on nurses not accustomed to dying patients, and they did not have the ready experience to prepare families. I had thought the better move would have been to wet-lease the palliative unit to hospice, to keep the excellent care, but lose the mortality staristic. The move was made by the same kind of people who gouge the medicare system: they were more interested in being cimfortable with appearances than in the comfort of patients, families and staff.
It’s so rewarding being the positive bridge between the life and death of my elders (and occasionally kids). No matter what they’ve done in their past, they always have a friend before they die. It’s beautiful. I love working in hospice.
I worked as a social worker for a hospice agency and it was the most fulfilling work I've ever done in my entire life. Hospice is such a wonderful misunderstood thing.
@@lauraska95 I helped a lot with end of life planning; funerals, cremations, etc. I explained options and provided short term counseling to the patients and the family members. I also completed admissions. I explained what hospice entails, our role, and how we can best help patients take control of their care. I spent a ton of time dispelling myths that as hospice we don’t speed up death, we just don’t slow it down and our main priority is the comfort and dignity of the patient and family. It was a wonderful job and I can see myself going back to it.
@@lauraska95I can’t speak for her since I only worked as a PSS in assisted living, so I only have second-hand experience, but most of the hospice workers I met would come in, do a full vitals check, and speak with the patients for an hour or two. I imagine home care is a lot different, though.
@lauraska95 hospice sw is there to provide social and emotional support, case management, resource management, counseling, assessment, family/caregivers support as well. They are members of the interdisciplinary team, and help determine treatment and care
@@gavo7911 Similar: After getting things set up, interviews done, and all that, subsequent visits were maybe a half hour or so with the patient, and then another half hour with the caregiver (separate meetings)
My mother was one of the English medical ethicists that helped introduce hospice to the US back in the 50s and 60s. At that time dying patients were not allowed extended visiting hours, full power pain relief drugs and many other things we now take for granted. It took decades for it to be accepted and implemented. Individual units of hospice care that maybe failing their patients are betraying the trust that was the original purpose and hopes of those individuals like my mom.
Mom died last week nearly 100 years old and remains a hero to thousands of families in our part of the country.
It was because of hospice my siblings were able to visit my dad during April of 2020. We lost him to covid but my siblings were able to take turns seeing him at a time when other patients couldn't be visited. Your mom helped usher amazing thing to the US.
All the love to your mom. Hospice allowed my beloved grandma to have autonomy and dignity when she faced death, and she went peacefully. 🤍🕊
Because of your Mother, my Dad was given a pamphlet of what he wanted done in the event that he was to die during complications while they gave him his Pacemaker.
As terrifying it was to think of losing my Father, I am glad he was asked for what he wanted to happen in the chances of him dying.
I thank your Mother for the chance for my Father to have that choice.
Your mom is a hero to me and my family. My grandma passed in hospice earlier this year, and we are grateful that she got what she needed and that we were able to spend as much time with her as possible.
I am so sorry for your loss. Thank you for sharing a bit of her story. Your mother's work helped make a difficult time more humane for generations of people.
I'm a hospice nurse. At the last company I worked for I only did admissions. If the doctor and I decided a patient didn't qualify for hospice based on our assessment, my managers would try to convince us that they actually did qualify so that we could hit our admission goals. I refused to admit a lot of patients that I was told to admit because if I documented what my managers wanted me to say, I could get hit with committing Medicare fraud. It was gross, and we had a lot of patients on service with dementia who were not far enough along in the disease process to qualify. The only way out of this is to make Healthcare a right and not a for-profit industry.
The company I work for now is much more responsible about admissions and treats the staff much better than my last company. Hospice is a great service and I love it, but the industry around it is absurd.
Please report the company you used to work for to Medicare for fraud or possible fraud.
By any chance did you work for Samaritas in michigan? Because we had that happening...ex samaritas here.
I worked for a hospice company in VA. There is no way we would “fudge” our assessment to meet hospice criteria. The only thing I wished was different was people accessing hospice too late. Many thought of it as “giving up”. Every single family I worked with said they wished they had called hospice earlier.
I had a similar issue when I was a hospice nurse. They didn’t tell me to outright lie on the paperwork, but they would twist the existing information into something they could use.
You are absolutely correct. Corporations need to stay the hell out of our healthcare. They will only want to incentivize disease management at very high costs, not cures. Cures don't bring in more money, that is why healthcare needs to be a government service. If government provided our healthcare they would incentivize preventive medicine and actual cures to SAVE money and it would be in the patients best interest. Corporate healthcare is about slashing costs, limiting services, denying non-critical measures. All reasons our healthcare system in America is completely broken. Don't believe the corporate lies either, they have no monetary reason to tell you the truth and monetary reasons are the only thing they care about.
The same thing applies to the penal system (we don't want to incentivize crime we want to change behaviors of criminals), but corporations will want to make sure the jail cells are always filled and will rail against any measures to lower crime rates because it hurts profits.
Some things should never be in corporate hands; those are just two examples.
I'm currently on hospice with terminal cancer. Treatments stopped working, and after doing multiple clinical trials, my body is just tired. I'm with my second hospice company, and this one is great. My first one wanted to dope me up on morphine and curl up and die. I did what they told me to do, to revoke hospice and go to the ER if I needed it, and then they kindly invited me to not come back on hospice. So I found a new company that I really like. They're wonderful. Even when I did revoke hospice and ended up in the hospital for almost 2 weeks, they were still checking up on me and caring for me. Where the other company basically wanted to just let me die. It's been really nice too, because I'm still young at 51, and they are there to take care of emotional needs of my children who are teenagers and in their early twenties. So I've seen the good and the bad of hospice. It's nice to know that there are people ready to help my family through my transition, as difficult as it will be.
I'm happy that you found decent people to help you through this transition. Love to you and your family.
So thankful you found the right one for you. My love to your children, and to you. Unfathomable how difficult it must be, but hoping you are all surrounded by love.
Ask if you qualify for psilocybin (magic mushroom) therapy.
@@rossi5839 I've had several mushroom trips, and they were amazing for me! I would definitely not be as okay as I am if I hadn't had them. They were life-changing.
@@rossi5839I have a customer in a wheelchair with one leg and he is always so happy. Magic mushrooms changed his life he says. He's the most ecstatic person in the room and goes on and on about how great life is and life's so beautiful.
Some things simply should never operate for profit:
1. Hospice and Palliative Care
2. Curative Healthcare
3. Education
4. Corrections
Well said.
Don't forget law enforcement and fire service.
But who’s going to get paid for educating people if the EdTech corporations don’t? The teachers and tutors??! Impossible!! 😂
@@casualeann pay the people who literally shape the minds of our future leaders and innovators? what a ludicrous suggestion. 😂😂😂
Municipal Water Departments
As an EMT in Arizona, I've reported hospice care centers for abuse/neglect more times than I can count. It's at the point where if we get a call to a hospice/care center and it's actually nice with attentive nurses, we're shocked. Hospice, rehabilitation, long term care homes, and assisted living absolutely need more regulations and oversight. We can barely take a box of gloves from a hospital without going through two keycard/keypad doors to a room with 4 cameras in it, there's no excuse for these places which serve our most vulnerable populations to be such a nightmare.
I only spent 4 weeks working in long-term care/rehab facilities while getting my NAC in Washington state. I decided that the 50 cent/hr raise in pay was not worth the added stress, I'd stay with in-home care. And that I'd end my own life before I spent a day in a nursing home as a client. I'm sure there are a few good ones, somewhere, but I'm not willing to see if I can find the needle in the hay stack.
@Kirigiri And, yet--here we are. Republicans would argue for less regulation, but that's not is needed in these situations. Any time there is money involved there are going to be people who take advantage of no oversight.
@KirigiriOnigiri thank you for sharing your experiences
yea but that would require effort and getting rid of exploitations......why the hell would we do that?
my son is an EMT that works now in a level one trauma center and has done the same thing! thx! from humanity!!!
I very much appreciate the producers of this show making the main stories of each episode available for free to the public. So much great information that gets spread further than if it was locked behind premium cable channel subscription costs.
You make such a good point. Honestly, I grumble at the parts of this show I Can't watch. However, to your point, it is truly a public service that the show makes their meaningful reporting available to anyone who can access TH-cam.
Ads don’t even play on TH-cam during the episodes. The show can lean a little left for me but I love how in depth they go and I eagerly await new episodes.
You can thank the current Business Daddy, whoever it is (I can't remember who bought AT&T). They're the ones making the show available on TH-cam. 😊
Isn't that what's happening. We're literally watching this on TH-cam right now.
We need more people like the Last Week team in Congress.
I'm one of the lucky ones. My mom was in hospice for the last three months of her life. She died of brain and lung cancer at the end of July, and the hospice workers were fantastic through the entire process to make sure that she was comfortable, not in pain, and had everything she needed to keep living for as long as she had left. My heart breaks for all those who have suffered with bad hospice care providers because it really can be such a supportive and essential service.
A Metastasis is truely horrifying form of cancer with incredibly low chances of survival.
Rest In Peace, I'm sorry for your loss
Sorry for your loss. My mother died July 29th. It’s weird, it was a long process, my mom’s death, it made me believe that it would be easier to grieve. Jesus, was I wrong
My mom died recently and she had good hospice workers too.
Deepest condolences
I've been a hospice nurse for 20+ years and it's an amazing service. The for profit corps who own most of the agencies now are pure evil and have destroyed something beautiful.
It’s horrible what corporations have done to hospice, it’s profit over patients
How do you find an actual good hospice company other than google reviews
@@tioswift3676 Look for a non-profit company. Not only are they truly out to help the patient but the caregivers usually get paid a little less than other nursing jobs, which means that with there being an open job market for nursing right now, that would be an indication that they truly enjoy doing hospice and are dedicated to what they do.
There is this book I recently finished reading its called The 23 Former Doctor Truths by Lauren Clark, Its full of secrets about modern health industry and my routines started to change so much! I appreciate people like you and these good doctors!
Thanks for sharing that
Im going to read it
omg Love that book, rachel is amazing
I would highly recommend it as well
Thankss
Human compassion drives many, many great ideas. Human greed ruins nearly all of them.
My husband has lung cancer and this couldn’t be more timely. We were actually looking into palliative/hospice care at home. This is very vital information for me. Thank you
Bless you and your husband❤
@@charlottabrower7968 Please don't let this scare you away from seeking hospice services. The hospice industry is motivated by profits and it's a massive problem, but most hospice workers are genuinely motivated to help their patients above all else. Read reviews of hospice companies and don't be afraid to switch hospices if one does not work out. I'm sorry about your husband's diagnosis, cancer is the worst.
My mother is currently in hospice care at home. I will tell you now, it will be rough. And do everything you can to make sure that every single helper is on the same page as things draw closer to the inevitable. But also there is one thing that this week has done, and it has given me the chance to tell her how much I love her, to say all the things I didn't get to say to my dad when he passed, to let her know what she means to me and how I'll be okay. It helped me come to terms with what will be a huge change in my life and let her know what I plan to do to move forward. It has shown me all the good people in my life who have come out of every circle of friends to offer care and support. And most of all, it has given me the chance to say goodbye.
I've done all I can. It's just keeping her as comfortable as possible and waiting at the shore for the ship to come in and take her to where she'll be for her next phase of existence.
My heart goes out to the two of you, and if you believe in any kind of faith, I hope that the divine presence smiles down upon you both with peace and compassion.
I hope you’re doing alright, and that your husband is comfortable.
Sending virtual hugs and supportive vibes. Make sure to take time to cuddle some puppies from a local shelter/rescue.
i’m a hospice nurse AND my mother just passed in hospice. You definitely have to be careful (as with anything) but please remember hospice can be immeasurably helpful. But I would NEVER work for or use a for-profit hospice
That is the big point I think this show missed entirely - the non-profit hospices are generally wonderful, the for-profits are the ones to avoid. How did they miss that?
The fact a company can scam over $999million, and settle for $75million, is insane. Our system is broken.
From my understanding $999 million was the total revenue and only part of that was due to a scam.
Often with these things the issue is to proof in court every dollar of scam...
@@Martin-jm8wi...which is broken as hell
and the lawyers got a third....
It’s WILD how many health care fraudsters Trump pardoned or commuted.
Truly the third world.
I was a hospice chaplain. Was once called by the corporate overlords because I spent 90 minutes with a patient. I got chewed out because Medicare only covered 30 minute visits with the chaplain. They were more concerned about the billing than they were the patient's care.
Also, we had a doctor on staff but he only came on Thursdays to our meetings and signed off on nurses notes. Never once visiting patients in home, at least while I worked there. I even asked my boss, hey does dr. Go visit patients and she laughed. He did bring in bagels each week, which was nice.
@@jayfabethat's horrible. How can he call himself a doctor ..can you imagine a mechanic coming in and looking at notes about cars? Or a plumber, and you getting paid to minister to people is shocking to me. Who gets that your church overlords? The Vatican or do they pay you directly? Per half hour? I dont even comprehend that.
That’s how literally everything in healthcare is.
@@serendipidus8482certainly you knew that ministers and priests and all religious leaders….. get paid right?
@@nataliaalfonso2662 no... they get paid a stipend by the church for their living and what they do within the week whether they spend 59 hours with a dying person or spend all day eating buns they get paid the same living stipend ... not paid for every 30 mins ..Jesus mary and Joseph what have you done to the church in america? You've turned it into some sort of capitalist venture for profit? Disgusting.
Both my parents died at home with me and hospice. Experience with mom was phenomenal. I don’t know how we could have done it without them. My dad was a vet and we went with hospice his dr recommended. It was horrible. Had to do intake twice, nurses just didn’t show up, and didn’t care. I called the regional executive director. She basically said “yes, and….?” If you have hospice you can change at any time . An employee of the crappy company told me this and said this was regular business for them. We went back to company who cared for my mom and had another exemplary experience.
Switch if you are not satisfied!
Thank you so much for covering this topic. Growing old in America is pretty horrific, particularly, poor elderly. More needs to be done for the elderly/disabled.
Why did the flamingo doing happy feet shatter me so thoroughly?
Flamingos burned you so hard you now need hospice.
I'm literally in tears over here. He put on a little show for her. 😭
@@ThePotatoad Yeah, seriously, the flamingo bit, especially when Peggy got to pet her, made me cry a bit
Oh me too! What a cutie, made me accidentally say “awwwww” out loud.🦩😍
Because you have true compassion and empathy, it was a beautiful sight!
At age 78, my father went to hospice for terminal cancer. He was one of the lucky ones in that he wasn’t suffering with much pain. A few weeks in, I spent a week in the hospice with him, same room, and noticed that they kept him doped up pretty good. Just as soon as he would start to come out of it, they would dope him again. I questioned them strongly on the amount of meds given he wasn’t in much pain. With the reduction in meds, he was his old self again so I took him home toMom.
They had had a very happy 58 year marriage. They were able to spend the next 5 1/2 weeks doing what they loved best, which was just living a quiet home life.
After that time, there was no denying that it was time for him to pass. We took him back to hospice and he died in his sleep a few hours later.
I always say that we need someone with us 24/7, in effect to guard us during our most vulnerable time ever during hospital stays.
Question authority.
-Albert Einstein
I am an admission nurse for a non-profit hospice. I would never work for a profit-based hospice as I find the idea of making a profit on people’s deaths as reprehensible. I see the marketers for profit-based hospices in nursing homes and hospitals, chatting up clinicians and administrators, I see the gift baskets in the case manager and social workers offices, all from hospices that are trying to make a profit. I’ve spoken to other hospice professionals who have quit those hospices because the business model is to have admission nurses work on a commission-only basis, fueling the practices and scheming that John talks about here. Hospices should NEVER be allowed to exist as profit-based companies.
TO reply, the non profits especialyl in SW Ohio here have become these profit driven machines. They convince families they need IPU care when in fact, they could be at home on CRisis CAre. HOwever, that doesn't pay enough so families rip up their lives to go watch their family die in a sterile building. The smaller for profits are not all money grubbing, some of us made an alternative to that uncaring nonprofit to give better care, and that is why we excel and provide unpaid services like Bedside PResence in the last 72 hours of life regardless of medical need.
❤
People have always profited of other people's death. We have a saying "One man's death is another man's bread". It's not the profit part that is the disturbing part, but the complete lack of ethics in jacking up those profits. As a worker you want to be compensated for the work you do. As an investor you want to be compensated for the investment you make and the risk you take on that investment.
People working on a commission-only bases is dubious at best. It delegates the risk of doing business to workers. That risk is why profit goes to investors. That is their compensation for the risk they take. Workers need to be compensated for the hours they work. Remove the incentives for workers to engage with unethical practices.
@@ralfvandeven3155just because something has gone on for a long time doesn't make it right
Same with skilled nursing facilities/ nursing homes they shouldn't be allowed to operate on a for profit model.
It’s funny how this guy starts every episode with the most grim titles, and still manages to get his audience laughing 😂😂😂😂
True
Ikr💀
They are expecting still a hamster to eat a burrito, i guess😅
We did, during the pandemic. And it was still just as enjoyable. Nice try
Yes that is what happened thanks for summarizing
Hospice made my mother's last days beautiful. They helped move her in to my home, had someone stay with her and I while my dad rested, made sure all her needs were taken care of with me so she could die with the dignity she deserved surrounded by family. Thank you hospice, and I devoutly hope more people can get access to the kindness and respect for life my family had from hospice services.
My friend entered Hospice after spending almost a decade fighting cancer. When she went into to hospice, she passed three days later. She was only 30yrs old and was such a kind and generous person. i think that when she entered hospice, she realized she could finally rest.
That or the hospice is secretly evil.
@@HashknightGaming not cool
@ytgytgy but happens too.
You can usually not tell, is it true or false anyway so she thinks she can decide what to do and what not
@@ytgytgywell it may be true cuz everyone that I know that's ever been in hospice has died pretty soon they always put people on liquid morphine and some type of benzodiazepine which we all know causes respiratory depression which is where you stop breathing and die
John Oliver: There's a lot of hospice fraud.
Rick Scott: Amateurs.
Thank you for remembering our former Governor and current Senator from Florida, and his massive Medicare "fraud" (allegedly).
👍👍🤣!
😂😂😂
This is an underrated comment
@justine How did Rick Scott escape justice?
My grandpa is on hospice now. He's been suffering for so long with chronic wounds that have led to a leg amputation, diabetes, paraplegic, and CHF. I'm so glad that he has this option and is at home surrounded by family and getting the support he needs
Yes! Hospice music therapist here! Yeah, all of this is so accurate. The live discharge rate of the hospice I work for is heavily scrutinized by our business daddy. And we do occasionally get patients who stay on hospice for a year or two, but the nurses have to show that these patients are steadily declining in order to keep them on service. Some people just decline very slowly. But five years?! That’s an insanely long time to be on hospice. I think the most I’ve ever seen is three. I feel terrible for anyone who got scammed by these hospices, particularly the people who didn’t receive services. Shame on anyone who takes advantage of a dying person.
🙏 Amen
They killed my mother within four days
wow so they do exist? we were told so much when mom went on hospice. been over a year (dementia). can count on one hand the chaplain visits and then 2 haircuts. no art, music, walks, companions, visits... they charge medicare a fortune yet all these services they can't provide? but thank you for doing what you do. I know you touch people and make such a huge difference in patient and caregiver lives.
@@domino427family Oh no, that's so sad. So sorry your mom was deprived of the services she deserved. Yes, my hospice provides massage therapy, music therapy, social work, chaplain, bereavement, volunteer (companionship), and nurse/aide services. Through these comments, I'm beginning to really feel the huge discrepancy between the hospice services and quality in my area in Iowa versus other areas of the country. It's quite tragic 😢
I have a few patients who have been on for 3-5 years. Many of them are over 100 and/or extremely underweight. It’s very obvious their body is deteriorating. They are just declining sooooo slowly. Hospice does not (should not) kill people. So we follow what the person’s body is showing us. How could we discharge someone who is 80 lbs and 105 years old? We’d be monsters. We jokingly say those people are “suffering from good care”. That’s the sign of a good facility that is keeping these people alive and following their body, not doping them up or leaving them in dirty diapers.
@@domino427familywe used to have music art and massage therapists with our hospice company. They got let go because of budgeting. The rest of our team is still so upset by it. The expressive therapists are incredible on hospice. Especially for those who are so lonely and isolated. Thank you for what you do.
my father is a hospice nurse. he says it’s an incredibly fulfilling job, helping people relax in their time of greatest need
Bless him
My stepmom is a prostitute and she says the exact same thing about her job.
It’s never the nurses, it’s always the admin that are the problem.
i’m a hospice nurse as well. no other job in my nursing career has been more fulfilling
My mother was on hospice for her last few weeks of life. First day, we gave instructions to the night nurse to make sure she got her meds at the right time, and the nurse slept through the night on our couch and did nothing. My mom went nonverbal after that, which was unfortunately before all her kids could make it down to say goodbye.
I'm not saying that my mother would have made a miraculous recovery, but the fact that someone who was being paid to watch after my mom failed to do so is insane.
My father is still in a legal battle with the hospice company to try to recoup some of the costs for the down payment they had to make for their negligence. It's incredibly frustrating, especially since he is still grieving.
Thank you for this episode. My grandfather just passed with us and hospice providing care. I'm so infinitely thankful for those nurses. I'm also thankful for life, the timing of bringing me my favorite show with the most appropriately timed episode. Thanks John you've touched mine and probably countless others lives, never stop covering these hard topics. There will always be people dealing with these hard truths. Thanks for 10 years of amazing work.
My condolences ❤
I am an atheist. I don't believe in the existence of God. There is insufficient evidence or rational justification to support the belief in any gods or supernatural entities. I rely on reason, logic, and empirical evidence to form my worldview and do not find compelling evidence or arguments to support the existence of god.The universe is governed by natural laws and forces, rather than moral, spiritual, or supernatural ones. As an atheist, I reject the idea of God. I emphasize the social and empirical nature of inquiry and prioritize scientific solutions to intellectual problems. There is an intrinsic intellectual conflict between faith and science, and that it inevitably leads to hostility.
@@snehashispanda4808I’m an atheist too, but how is that relevant to this comment?
By sincerest condolences, and I hope you and your family are managing well. 🫂
@@snehashispanda4808dude wtf. The guy’s talking about his recently-deceased grandfather and you decide that now is the time to go on an anti-religion diatribe?
My grandmother had it in 2010. She actually lasted longer than any other in their system. The nurses who came to my Mom’s were kind and thorough. Not only did they do the medical things, they helped Mom psychologically get through it. I would hope that everyone could have had that level of support.
My husband is in hospice now and we don’t get any support. We had an incident just yesterday morning and I called them and I got a recording. I left a message for someone to call me as soon as possible and no one ever returned the call. I wish I knew a better company to provide this because the one we are using is horrible.
Rest In Peace, I'm sorry for your loss
Many providers, especially outside of USA, are pretty decent.
Even within USA there are a lot that are fine, but their system allows for too much grift or outright fraud.
That hasn’t been the experience of the last 3 people I’ve known. Pretty evil whenever they’re pushing hospice onto a lady who’s still well enough to attend public functions & wasn’t exactly wasting away. And then my bf had the sweetest lil aunt, who probably had another good 3 years, and they (& her son) were insisting that she needed medication, when she was being very verbal about not being ready. She was gone within 2 months with their help, & her son had blown through his inheritance within 3 months. Makes me grateful that I’m estranged from family.
That sounds hard. I'm sorry.@@Sandi-ke9mi
Hospice Nurses are some of the sweetest, most caring people in the Healthcare industry. When my Grandpa was dying, he chose to be at home, and his hospice nurse was the absolute best! She took amazing care of him in his last days, and explained the "death process" to us because some strange things can happen and she put us at ease.
When he did pass, she cleaned & dressed him in his chosen burial outfit and that was a pair of sweatpants & his "Monona Home Talent" baseball sweatshirt which my uncle's play for and he was the coach of for a while because he wanted to be comfortable for his eternal nap... ❤
He passed 15 years ago today... RIP Bumpa
our local hospice gave my father dignity, my husband grace, and my mother compassion. I will always be grateful to them.
Good Lord, I'm so sorry for all your losses. I'm glad they all were cared for. ❤
Fake
@@thehegemon996 what's fake? hospices? they exist, so not that. what's fake? all my losses that hospice has helped me through? if that's what you meant... *losing my parents and my husband is "fake", you jackass?* my grief is fake? that's good to know. I should just get over it then, should I. right.
@@thehegemon996 how so?
I am genuinely glad for your family if you found a company to actually care; our local hospice stuffed my grandfather into a small room with another man, and fed them pb and j sandwiches twice a day everyday (but its okay because on Fridays he can have a dry chicken sandwich). Checked on them 1-3 times a day. Let him rot for 2 and a half years while milking him as much as they could the entire time. Not the employees fault, but it's definitely a shit industry through and through. There is no chance in fucking hell - which thankfully doesn't exist - that I let my parents die in this country.
(Fun Depressing Fact: The other man in the room with my grandfather, had been in hospice for 13 years after suffering a stroke. He was completely there mentally, miserable, just unable to walk around on his own. They cut corners and lifted him without the proper equipment, and dropped him. Breaking his hip. Leading to his death a few weeks later. It was a really great time to hear an aging grown man crying on a daily basis when I went to visit. Listening to a man sob about how the nurses killed him by dropping him; knowing full well that people his age don't recover from injuries like that - was extremely rough and I don't think I'll ever forget those nights.)
My own father and brother have been under the care of our local hospice in Ireland. My father died peacefully last week and we couldn't be more grateful to the caring and understanding hospice staff ❤❤
My condolences ❤
My condolences 😔🙏🏽
I also live in Ireland, our healthcare system is far from perfect, but I think we have a very good hospice system
I'm sorry for your loss.
So glad to know you had the time and attention to have a memorable goodbye. 🖤
I've been waiting over a decade and a half for someone to expose hospice like this. thank you John Oliver!
Not to be a buzz kill, but Hospice Nurse Julie is seriously great. My 84 year old mom had a major stroke last year and requires 24/7 care, and her channel has provided me with so much invaluable information as to what to expect going forward.
I'm subscribed to her, too. She is great.
Let's hear it for hospice nurse Julie
You're not a buzzkill at all! You're sharing good information.
I'm glad you were able to find some comfort (on TikTok, of all places!) in a really tough time. Sending good vibes your way.
@@wh1skeys1erra Thank you so much. Maybe not a buzz-kill, but a joke-killer. I'm too old for TikTok, so I found her on TH-cam. 🙂
I am so very glad you posted this. Hospice Nurse Julie helps her subscribers understand the processes of death and her compassion for her patients is palpable. I felt betrayed, actually, when I saw her being made a butt of jokes on this program.
I used to work for a wonderful nonprofit hospice. The staff, Medical director was a wonderful caring MD. When I started there it was the first time I felt like a "real RN" after years of working ICU. It was wonderful place to work. I was allowed to spend as much time needed to give good care. Then one day the board hired an administrator from a for profit Hospice. The changes the administrator implemented was what Hospice was supposed to be trolling ER, Skill Nursing facilities etc for potential clients. There should be no profit for caring for the dying. I quit and I was so disillusion in nursing that I quit nursing altogether. Hospice can be a good service to help they dying pt and their family and should not be used to make a profit.
This is similar to what happened here in CT.
Very true but unfortunately as with many industries that shouldn't be for-profit, I don't know we can reverse the trajectory at this point.
I am a hospice nurse and I’m in a very similar boat right now. Doing hospice makes me feel like a “real RN” and I’m truly helping people, just in a different way. I love what I do and caring for my patients. You meet so many people with very interesting lives and customs and cultures, and it’s amazing.
But we’re kind of in the same boat, hiring administrators who’ve never touched a patient in their lives making the decisions. It makes the work not enjoyable anymore because we’re always worrying about money and budgets, not the humanity and care for people at the end of their lives.
I’m actually at the point in which I’ve considered quitting hospice, which breaks my heart. I have a second job in a different area of medicine to fall back on that I also enjoy, but I feel like I’d be betraying my patients if I left hospice. I know their care and experience doesn’t solely depend on me, but I advocate hard for my patients and work tirelessly to ensure they’re happy and comfortable, and that their loved ones can feel relief knowing their loved one was comfortable and peaceful. ❤
Our hospital here in Asheville was wonderful, with a state of the art cancer center & a national reputation. Then it got bought by a big corporation & all the oncologists quit, the nurses have gone on strike, the state Medicaid office put them on probation, & the county is calling on them to sell out to a more reputable company. It’s so upsetting.
😢that is so horrible we need good nurses like you❤
I am a retired, disabled RN, who worked at our local free-standing Home Health and Hospice in the 1990's. I worked in the trenches, so to speak...after losing my father to a drunk driver during that time, I was forced to move away from my beloved role. I then worked for a local HMO clinic for 13 years. That was wild in it's own way, mostly due to the takeover of corporate medicine, big pharma, etc. I've seen a lot in my day. I was wondering how you could spin something like Hospice, which is still a sacred practice to me, but we no longer even have our wonderful community hospice, which saddens me. Seeing all of these unconscionable stories on this show, gives me another round of soap for my soap box on the corporate medicine, big pharma, and the oligarchy robbing us blind, yet also the show provided the best medicine for whatever ails you--laughter!! The Matt Gaetz comment...classic!!
I haven’t watched this episode yet. My mother’s funeral was a week ago today. She was on hospice. I can’t tell you how many times a day I see something that smacks me in my face with a handful of grief. It’s everywhere and it fucking hurts. Spend time with your loved ones.
Ik it’s probably the LAST thing that you want to hear right now, but that horrible blow does soften with time. Some days are tough, some are horrible, and there are some good ones thrown in there, too. I lost my mother unexpectedly last fall, and the first sleepless nights it felt like my heart was in a vice, actual physical pain. But it WILL get better. Remember her, especially the funny moments, and talk to those you can trust. Love and light to you and your family ❤
@@casualeann I appreciate you. I know it’ll get better, and I know the sudden tears are necessary. I’m not one to run from emotion, I cry tears of happiness for strangers I hardly know. I hate seeing my kids so upset, but it’s helped me realize that life is temporary and I need to do everything possible to live a long life for them.
When my grandmother died in the 80's, I remember my Mother saying "Hospice is a wonderful organization. They come in and take over and they take care of everything." It's so sad that something so wonderful can become so corrupted by greed and malice.
Hospice nurses are angels on this earth. My parents both benefited from their kindness and empathy in their final days.
My grandmother had at home hospice as she died of colon cancer. I can't thank them enough. And man I miss her.
Sorry to hear about your grandma. Grandparents are just the best people.
My condolences ❤ I lost my grandpa in 2018, and we were very grateful for the hospice workers who cared for him.
My dad was also in hospice care 10 years ago for colon cancer. We thankfully also had a great team.
Knew this was going to be dark. Appreciate John for shedding light on injustices.
I’ve sat by the side of four family members going through hospice. Luckily they were all at the same hospice house, and they were treated very well and had a peaceful transition. Hospice is a great thing, letting people be comfortable in the time they have left is the least we can do.
"They have been taking sure my final six months were comfortable for the last eight years" 😂💯
My grandmother just passed away last month in hospice care after she had a stroke during heart surgery. She lived very far away so we could not be there when she passed, but the nurse that let us know she died said that she sang to her 10 minutes before she left us, and I will always be so thankful for that wonderful woman. I'm also grateful that she only suffered for a month before passing, I'm definitely one of the lucky ones.
nice work 😎
brutally accurate
there are 4 ways to make money in hospice
1 aggressive sales
2 relentless cost cutting
3 financial engineering (M&A)
4 fraud
I'm a hospice healthcare worker and have been for over a decade. Ty for this absolutely spot on assessments here. I went from facilities of various specialties(memory care, assisted living/apartments ect). I stayed at homecare because its really where hospice should be but I realize that is not accessible to everyone which is sad none the less. End of life care is so important to have better oversight going on, there is absolutely no reason these events and horrid tragedies should happen. Greed is why 100%. I absolutely loved every single person and family I ever cared for. CMS and many many hands in these pots need to be held accountable. Families deserve to be made whole period.
Thank you for doing the Lord's work.
Yes! 3 minutes after waking, 42 seconds after this video posted and I'm having an existential crisis. Thanks John!
Same!
Don’t you know Thursday is existential crisis day
@NathanSimonGottemer "existential crisis day" used to be sometime Monday morning, after a full "bender" weekend that usually started Friday night... Moving it to Thursday only fuels the need for a long weekend...
I always hit his videos when eating somehow.
The best way to get over existential dread is to embrace the fear. Go volunteer some hours at a hospice. There are numerous roles but the best and hardest is social visits to those dying without family or friends remaining. Seeing the dignity and grace of a “good death” and exploring beliefs about dying with those going through it is almost 100% guaranteed to move you towards acceptance and away from fear of the unknown.
I saw home hospice care with my dad last year - he did not have a good situation, due to his denial that he needed care for a long time, and my mother’s resentment of these “strangers” coming in to do something that she denied that she was incapable of handling herself. I mean, it got very bad. i tried so hard to get him better care that I ended up getting totally disowned by my parents. At least I got to tell him I loved him before it got to the worst point. But I missed his memorial service, and my mom and I have not spoken since then.
My brother recently died in hospice care and I was amazed by the quality of his care and the support they gave me.
Hospital or nursing home? I think the big problem are nursing homes and at-home PCA care as our father also received incredible hospice care while still in the hospital but dreaded the idea of needing to transfer to nursing
It feels so saddening how we all tend to be so amazed to find things that are as good as they should be in a fair society😢... I'm sorry for your loss
I was a hospice aid for several years and death was nothing to me...til one of my patients died from a sudden heart attack in my arms 😢 it takes such a strong heart to take care of others in their final days and i wish i could still keep doing that, because i loved my job and the people i took care of.
My father in law just passed away last week and was in hospice care, I am extremely grateful we had honest care and I saw first hand how much they truly cared for his pain and humility
I am sorry to those who got treated like this. Shame on them
We were victims of hospice fraud. Kickbacks to the board & care administrator. My mom suffered horribly because of it. Blows my mind that people can act this way, knowing they are causing untold horror. They should never be let out of jail.
I am so sorry you went through that. It is beyond the pale to deal with grief and full time care.
I still feel guilty. I just didn't know. Now the most important person I'm my life is gone.
My dad works in hospice care here in Germany. When I heard that 2/3s (?) of hospice companies in the US were for-profit, I knew what the problem was ... but even then I couldn't imagine things being that insane.
Healthcare (including hospice care) is not something that should be run as a business.
I mean tbf something being not for profit in the us doesn't necessarily mean it's any better than a for profit, just that by the end of the year they have no money left over after paying the higher ups salaries
I could not be more appreciative for the hospice care my wife got during her last two months. It was fantastic and made all the difference. That people would rip off dying patients is ghoulish.
My grandfather, who wanted to die at home, received hospice care after his terminal cancer diagnosis. They were absolute Lifesavers and couldn't have been more kind or empathetic. Thank you to all the good ones out there
For a brief second there, I thought you were going to say Reagan did one thing during his presidency to alleviate suffering (approving hospice). I was bewildered and had an existential crisis. Seconds later, you saved me from spiraling by reaffirming that Reagan was indeed one of the worst humans in modern history because his rationale for approving hospice was to save money on treating people. Now, that is the Reagan I know and hate!
Whats wrong with saving taxpayer money while providing better care?
Same!
Reagan was one of our worse presidents. It's fine to save money but care should come first as rationale.
@@karenv8351Reagan was actually worse than Trump (in terms of his long term impact). He was fake and knew how to charm people.
Reagan has really been underappreciated for the level of criminality in his administration and the venality of his policies. Hard to name any other president besides Trump who despised the poor and working class more.
I will always remember the kindness and warmth my family was shown in hospice as my dad passed from cancer in his final two weeks. I found comfort at such a traumatic time in my life at only 14. There was even a group of volunteers at the hospice who sewed a pillow out of my dad's shirts for me. I will be forever grateful for what these people do
I volunteered for Hospice for years. I assisted clients and their families through the toughest and scariest times of their lives. I made a great many friends that I knew I was not going to get much time with. It was simply one of the most rewarding and painful experiences of my life, and I wouldn't trade it for anything. Great story: a dementia client of mine that almost no one even in her care facility could understand anymore trusted me so much more than her care staff that she wouldn't let them take her blood pressure without me there. She told me we should go out with her husband (who had been dead for years) for drinks. She trusted me because I sat with her, and listened, and lived in her world with her. Her family, and so many other families, contacted me on their deaths to thank me for my time and effort. Obviously not why I did it, but it made me cry every time.
]p)))) l p
Appreciate this man, there will never be another, thank you John Oliver
Why are people complaining? Isn't this the world the Boomers wanted for us? Everything privatized? I wonder what the stock price of these "Hospice" facilities are? 🤑
My dad has great hospice in his last two weeks. We were really grateful. And they even had therapy for me and my other family members.
My grandfather who passed away back in May was a big volunteer for hospice. Helped raise $4million in southern Maryland and even helped build a hospice facility. He received in home hospice care for the last week of his life. Full circle. We all miss him.
Wow. Thanks for sharing. It sounds like he was an amazing person. What hospice did he help build? It must be one of the few good ones considering his history and work.
@@DaveHurka I don’t know off the top
Of my head. I remember visiting it as a kid though. It’s one of those things I was too young to know what was going on and it never got brought up until he passed away. He received the Presidential Volunteer Service Award
Thank you for this. Our hospice experience was traumatizing for me and my family. My dad was in pain and my mom was left alone to figure out his care. The amount of fighting I had to do for my dad on his last days to die with dignity left me with nightmares for months
I hear you. This was my experience as well.
this was also our family’s experience. i know so many who had wonderful experiences and i am so bitter that my loved one suffered so much. we had to spend so much time fighting when we should have been spending the last moments with her.
I was pleased that hospice treated my grandmother with the dignity she deserved- they changed her clothes twice a day, had aromatherapy, morphine, and kicked me out of her room: "please step out, we need to change her clothes". I thought they did well for her comfort and treated her with dignity. We might have been lucky; thankfully.
The wildest fact about hospice care that John Oliver missed, is that Dick Cheney still doesn’t need it. He’s like a real life Palpatine.
Somehow Dick Cheney returned
So whose worse than the Emperor? Just checking because at least Cheney is standing against J6 with his kid.
@@philipreeves9311 Color me unimpressed by Cheney or his spawn. Cheney, Rove and Bush walked so Trump supporters could rush and beat police while attempting coup. There'd have been no Trump if not for Bush lowering the bar so much, and Cheney was gleefully along for the ride.
When you’re rich….
Cheney had his first of 5 heart attacks in 1978, God has been trying to send him to hell for decades.
I've worked in Hospice for 21 years. There has been fraud like this since 2010 when the rules changed, and many 'independent' hospice companies suddenly popped up. The fraud has impacted us being able to deliver services like caregiver relief, and other services families depended on. The for profit companies like Vitas and others have made it much harder to provide good care to people. This is the minefield we navigate now to provide end of life care.
thank you for the work you do
Well said! (From a nonprofit hospice nurse of 25 years)
My Dad has been on hospice since may of 2020. I pulled him from a nursing home at the start of the pandemic. He was given 2 weeks to live. Tonight we watched the Bachelorette together. Being put on hospice actually saved his life.
I was against hospice, but weekly in-home visits, and someone I could call 24/7 made all our lives much easier.
I'm very thankful.
Why were you against hospice? Genuinely curious.
@@merkinidgit Mostly grief. I wasn't ready to accept she was that close to death. Also my view of hospice was they go away and sit in a room hopped up on morphine for the last month of their life.
Home visits are worth it but you pretty much have to “childproof the room” and make it very safe. But I’ve known children of the elderly who let themselves burnout and got frustrated and exhausted with their parents that could be as bad if not worse than the worst hospice places out there.
*Weekly* visits? That actually doesn't sound like much at all.
@@jonn.5568 They don't offer in home care, we had to hire someone to give her showers. This is a nurse who comes, checks her vitals, listens to her concerns, and prescribes medications. But it meant we didn't have to leave and go to the doctors anymore, which was becoming impossible. She wasn't able to handle car rides getting in and out of a wheelchair and sitting in it for an hour, and we couldn't handle constantly taking off work to take her to appointments.
So, my mom died of cancer in 1996. About a month before she died, when we expressed how hard it was getting to care for her personal needs. Her oncologist suggested hospice, but he made a full disclosure that he and other oncologists owned the hospice.
They got us the equipment we needed (bed rails, bedside commode, etc.).
A certified nursing assistant came for 8 hours a day. She showed me how to move mom to minimize her pain. A registered nurse came twice a week to assess mom's pain, and to change medications as needed. She came out to declare Mom dead (dad and I had been with her when she died).
I don't know what they charged the insurance company, but it was a lifesaver for me and dad. Dad wasn't physically able to do much. I was working full-time, and I would sleep next to mom's bed when the CNA wasn't there. They made a different time more bearable.
Okay, huge cheat code for everyone. Contact your local funeral directors, ask them who their favorite Hospice care personel are. They will tell you which ones are the most present, helpful for families, and concerned with actual patient welfare. Also, because of the nature of their work, they will also only recommend Hospices which work with patients who are actually dying.
Or they will send you on to the worst hospice because they supply them with the most customers
@@liamogorman3312 Unfortunately possible, because the funeral business is another major scam.
My dad spent a month with hospice back in April and we can’t say enough of how well they took care of him. We know we were blessed with a hospice nurse who fought hard to keep him comfortable. My heart breaks for those who didn’t have an advocate like we did.
Thank goodness for hospice nurses. My father had terminal anxiety and could not find rest, the hospice nurses where able to give him full strength opiod drugs to let him relax finally and he passed in less then 24 hours. He was so peaceful. the most peaaceful he had been in months. Dementia and alzhimers is a terrible disease and to see my father suffer was terrible but to finally have my mother get peace and see him in peace was all we could ask for. he was so worried. RIP Dad. I will always love you and miss you 8/6/2024.
Lots of love for you and your family in this trying time! 🫂
As an oncologist this is surprising to me. I do send patients to hospice, when we have run out of any beneficial treatment. In my 10 years of work, i never had a patient who came alive from a hospice. A live discharge rate of 50 percent. Wow
Some pts may go into hospice temporarily, for short-term on-site respite care if they have been under medical care at home. Caregivers need a "sanity break" away from the stress of looking after a terminal patient constantly.
Please focus on nonprofit referrals.
I now want a story centred completely about Rusty the evil doggo 😂
He knows what he did! 💜⚡️
You are a child
He's so loyal, he followed his owner to hell.
He's going to handle all the hospice fraudsters
Google Mr pickles
I'm so grateful my family had a positive experience with hospice care when my father passed. I can't imagine how awful it must be for these families who were neglected or taken advantage of. A death in the family should never be treated so flippantly. This is another example of why for-profit healthcare is a conflict of interest.
Both my parents received hospice support. My dad at home in the last 6 months of his life and my mom in an inpatient hospice unit. Both were incredibly helpful to them and to the entire family. Not sure how we would have managed without it.
Health care should never be subject to the free market, just like schools, streets, railroads, prisons, police, water supply and other basic needs. And as long as those needs aren't met, nobody should be allowed to own billions of dollars.
Medical services so obviously lack the necessary conditions to able to operate as a market that those who push for it to be treated as one are either clueless or they have their own greedy hands in it. Probably both in many cases.
I work for a non profit hospice. Not all of them are corrupt, for sure, but we often get called in when families fire another shitty hospice. The money first mentality is pretty shocking.
Amen! One of my biggest pet peeves as a non-profit hospice RN of 25 yrs. For-profit hospice will often dump them in the ER when their care starts to be difficult or expensive after milking their insurance for months/years, and then our ER winds up calling our nonprofit hospice to pick up the pieces.
I’ve worked in hospice in Washington state. I think some states have scammier hospices than other states. these scammy hospices are unrecognizable to me. I worked in hospice 3 years and never saw anyone on “continuous home care”. The most important thing to know about hospice is it usually consists of care in the home provided by family members with some nurse visits for management of medications - inpatient care is only for management of out of control symptoms. It is true that you lose access to curative treatments when you enroll in hospice, but you can ALWAYS choose to revoke if you change your mind and want to pursue treatment.
My mom spent a few years trying to get a diagnosis here in the States, but they just told her it was all in her head. She moved back to the UK to where they diagnosed her with ALS and provided her amazing healthcare, hospice care, and allowances to friends & family who took care of here at home. It was a comforting and humbling experience to see the kind of care they provided. She only lived for 3 more months, but she was with those she loved and was in her homeland. In the States, they would've snatched every dollar from her frail fingers.
Weird how putting excess amounts of money and profits without regulation creates corruption. Or as we in The United States call it, our entire economy.
As someone who was born and raised in a hospice, I really appreciate you covering this topic. Seeing those two old coots tantalizingly feed each other sliced vegetables really brought back some wholesome childhood memories. Thanks!
One thing that John did not mention is that hospices are required to evaluate patients at admission and at regular intervals while on hospice to recertify that they remain hospice-appropriate.
Due to the variety of disease processes, responses to care, and frankly will to live or die, it can be very tricky to determine the timing of someone's decline and death.
Hospice companies have to be willing to not only fudge the admission, but also ignore (or just not conduct) their own regular assessments in order to put/keep people on hospice without cause.
As someone who works in hospice, there are caregivers doing selfless and compassionate care in this space. And it's not as of people are lining up to spend time with, much less care for the varied and complex needs of, older and terminally ill people in America.
We saw multiple instances of them doing just that. We watched the video.
There's a lot missing in defining Hospice in this episode. For sure there's corruption where ever money can be made, but to the unknowing mind this episode can define what most hospices are and the extreme patient care and dedication each one gives to dying people. How about a lot of the patients are abandoned by their families thats one cause for long term patient care, or a lot of hospices are severely under funded or under staffed. Again, more needs to be said to defend this practice to not convolute people's mentality about Hospice.
@@MadPunky And this is where John often misses the mark.
If you're running the hospice correctly then this piece isn't about you.
It is important to put a bad hospice on blast or it becomes the norm like bad nursing homes are the norm.
Yeah, I think John Oliver should have spent more time on how horrible it is to WORK FOR hospice rather than hospice treatment. A lot of folks have great experiences with hospice, even though there are areas and hospices that give horrible treatment. HOWEVER, the actual issues are recertification, treatment and pay of staff, and how care is rapidly deteriorating while being propped up by staff who are literally working themselves to death to shield patients and their loved ones from that decline. We unfortunately have come a long way from Saunders and Kubler-Ross in this day and age of the suffocating cancer that is corporate America.
I worked for a hospice as a bereavement coordinator for 2 years. Our non profit hospice was bought out by a for profit hospice called Gentiva (owned by a venture capital firm). They implemented a bureaucratic system of management and made small frustrating changes to operations. In the following year a lot of dedicated workers got frustrated and left. Many who didn’t leave were laid off.
This is the sad reality of many health-care facilities/ organizations. Mental health facilities are especially ripe for the picking by venture capitalist. What kind of monster preys on those in need of medical services.
Ah, venture capital doing what it does best, buying a company and squeezing every bit of value out of it….
Gentiva is one of the worst but there are so many hospices under venture capital firms. There are people who start up hospices, throw a ton of assisted living people on their census by bribing the administrators and then sell. It’s truly a hot mess right now.
Thanks for continuing to talk about the brightest topics. You always brighten up my day!
My mom was placed into hospice in 1995. I was 14 so I didn’t really understand what that meant at the time. My dad took me to see her and she looked pretty messed up, but I thought she was gonna pull through. Ended up dying later on that night. That is a crazy place to work at. I don’t know how people do it.
I think like any job that sucks you just get used to it
@@sidvicious332No it's a special calling for medical professionals strong enough to handle it physically and mentally. Not "just another job that sucks"
I'm sad that nobody took the time to explain to you what was happening to your mom. May her memory be a blessing.
You cant mix "for profit" with "public service". It literally contradicts its purpose.
My dad is literally dying of colon cancer right now as I type this, hospice is denying him care!!! This opened my eyes and made me realize I have to fight for him!!! Thank you for making this episode.
Hospice was a blessing for my mother but also for my father and me. I'll always be thankful for their kindness.
My grandma went on hospice, got healthier, got off hospice and lived another 3 yrs. Hospice is a gift.
One of the things hospice does is stop any medications not providing immediate comfort/quality of life, while ensuring relief from pain. I’ve heard some people, relieved of drug burden and now comfortable, show quick improvement and love much longer than expected! ❤
I almost came to blows with my father's hospice nurse. He was sending lab techs to my parents' home to do his job. When I found out, it was go time. He lost his job.
I provided pediatric hospice care when I lived in the states. My father had home hospice for 5 months. We were very fortunate to have wonderful care givers and nurses.
Pediatric hospice care is another level. My god I can't fathom Hospice care for children....how do you do it?
@@MadPunky it was difficult, but I loved supporting the families and kiddos. I did it for only a couple of years. I’m still in touch with 2 families. I have a box of wonderful letters from the families.
"Hospice industry" is one of the more frightening terms I've heard.
It is also one of the most American terms I ever heard...
Tbf to america, we also have things like this in europe
"Hospice scam" is definitely in my top 3
@@AlzheimersCaretaker I salute you and your dedication very admirable. Though it is a sad state of affairs when you can't trust your care facilities...
Good point. Important for it to stay not-for-profit imho
I'm in Canada. We tried at-home care for my grandpa the first week he was diagnosed with terminal cancer, and it was very difficult because we could not provide the level of round-the-clock care he needed. Finally, we transferred him to a hospice facility, which cost some out-of-pocket money but was still part of our provincial healthcare system, so definitely up to the standards of a hospital. I
t was so much better after that. The staff were experienced and so caring; he had family staying with him all day and night, the level of care was above and beyond what we could give him, and the burden of taking care of him was lifted from my mother.
He only lived another week after being in hospice.
I wish we had put him in the hospice right out of the hospital. I think he would have lived longer, and his death would have been a lot less painful for him and traumatic for my family.
I hope someday you in the US get a health care system that doesn't treat patients like products on a factory line, and I'm so sorry for any American who is left to avail themselves of the profoundly broken system.
Thanks for this John. My father was in hospice his last year of life, at home during the pandemic (he had terminal dementia). Throughout his hospice care, his dementia symptoms were "treated". He didn't need pain abatement until the last month or so. He was under very good hospice care at their facility for about 2 weeks, while I was away (I was his primary caregiver), during which, he got excellent care at the hospice facility. But, The hospice, a non-profit, could only keep him 2 weeks, then he had to go to a nursing home of my choice under a Medicaid program for another 4 weeks. From day 1, he received sub-standard care ( he fell out of bed and was injured the second night because they changed his medication). When I was able to bring him home again, it was a struggle to get his appropriate meds ramped up, but still it was a steady slide into death. I desperately needed that break after almost 3 years in my care. But, his close to final weeks were needlessly terrible - NOT because of hospice. The hospice care in nursing homes is all about minimal care, and profits for the private owners. I could go on.
My Father-In-Law died from cancer on Hospice. It was horrible. He was seen minimally, but they did not work with my Mother-In-Law at all about what was happening or what to expect. They dropped off a brochure and a little book and that was it.
He laid in his own urine for days because we could not physically change the pads that they said we should be able to without their help.
He died horribly and it haunts all of us still. I interned at Hospice 20 yes ago. I know it wasn't supposed to look like that. Later, we were told it depends on the nurse you get. Some are really good, some don't care...clearly, we got a team that just did not care.
I have no idea how much money they charged, but even free was too much. All they did was make sure he had a hospital bed and meds.
All the people defending the hospice nurses...I do hear you and yes, clearly there are good nursing staff out there. But that doesn't make the crappy stories and the fraud less true.
I like to volunteer at my local hospice center to help out when I can, I really am happy to see the different activities that this one provides. It has an outside area for gardening, which can be used to help patients relax and remember loved ones. It provides cooking and baking activities that can help the seniors reminisce and stimulate all five of their senses, and it has a television lounge where they can watch the recordings of nineteen ninety eight when the undertaker threw mankind off hell in a cell and plummeted sixteen feet through an announcers table.
My grandfather died last month of a brain tumor. He went on hospice in the afternoon, but passed away that evening because the damage was that severe.
Sorry to hear that
You're a downer dude.
My condolences ❤
I feel ya man, my grandfather just passed away a couple of days ago from multiple organ failure. I never met anyone on my father's side of the family, so with my grandmother passing in 2019 and my grandfather passing a couple of days ago I no longer have any grandparents left.
I’m so sorry for your loss. My dad passed last week b/c of the same thing.
I used to work at a hospital that had a dedicated palliative care unit, with nurses familiar with all aspects. Families gave each other moral support, and helped provide comfort to each other whenever a patient died. Nurses were always available, and they coped well because of the ongoing support group environment.
A new hospital administration disbanded the unit, because it "raised mortality statistics" and instead, dispersed terminal patients to other specialty units, with regular nursing staff, and listed them with the local hospice. Coping and mutual support were gone. It was harder on nurses not accustomed to dying patients, and they did not have the ready experience to prepare families.
I had thought the better move would have been to wet-lease the palliative unit to hospice, to keep the excellent care, but lose the mortality staristic. The move was made by the same kind of people who gouge the medicare system: they were more interested in being cimfortable with appearances than in the comfort of patients, families and staff.
It’s so rewarding being the positive bridge between the life and death of my elders (and occasionally kids). No matter what they’ve done in their past, they always have a friend before they die. It’s beautiful. I love working in hospice.
I worked as a social worker for a hospice agency and it was the most fulfilling work I've ever done in my entire life. Hospice is such a wonderful misunderstood thing.
If you don't mind me asking, what did your job entail? I'm studying to be a counselor and am interested in working in that environment too
@@lauraska95 I helped a lot with end of life planning; funerals, cremations, etc. I explained options and provided short term counseling to the patients and the family members. I also completed admissions. I explained what hospice entails, our role, and how we can best help patients take control of their care. I spent a ton of time dispelling myths that as hospice we don’t speed up death, we just don’t slow it down and our main priority is the comfort and dignity of the patient and family. It was a wonderful job and I can see myself going back to it.
@@lauraska95I can’t speak for her since I only worked as a PSS in assisted living, so I only have second-hand experience, but most of the hospice workers I met would come in, do a full vitals check, and speak with the patients for an hour or two. I imagine home care is a lot different, though.
@lauraska95 hospice sw is there to provide social and emotional support, case management, resource management, counseling, assessment, family/caregivers support as well. They are members of the interdisciplinary team, and help determine treatment and care
@@gavo7911 Similar: After getting things set up, interviews done, and all that, subsequent visits were maybe a half hour or so with the patient, and then another half hour with the caregiver (separate meetings)