News from the Noteworthy:
Have a plan: Start the conversation

New York State is 50th in the nation for hospice utilization, and I wish I knew why.

I believe most people know about hospice. It is a service that helps and supports those with life-limiting conditions to address their symptomatic needs. Additionally, hospice supports the patient families, including bereavement care after the patient passes. New York has a hospice utilization of 30 percent, meaning only 30 percent of those who qualify for hospice die with the hospice service. And for Medicare and Medicaid beneficiaries, it’s free. All of the services, prescriptions; emergency room visits; if necessary, hospitalizations; all covered by Medicare and Medicaid as well as by many commercial insurances.

The benefit is also good for six months or more of improved quality of life, not for the last days or hours. The word Hospice itself has a negative connotation, that is one of several reasons Catskill Area Hospice and Palliative Care changed our name to Helios Care.

When patients hear “hospice,” it’s like hearing the word cancer. Both carry a heavy connotation. When people hear Helios Care, we want them to know that we make life easier for patients and families.
In Otsego County, as well as in the Helios Care service area of Delaware and Schoharie counties, we are better than the New York State average. But that is little consolation to those who pass without the benefit of our services. Some other staggering statistics: New York has the highest Medicare cost for the last hospital admission, and more patients die in intensive or critical care than any other state in the union. Not at home with loved ones surrounding them.

We can talk about the cost of care, and the consumption of what are now more and more scarce resources for the care of the dying, but the real discussion should be about the dignity of life and choosing how we want to die. Until I came to work for Helios Care, I spent my healthcare career working in hospitals, and now it is my mission to keep patients out of hospitals and nursing homes unnecessarily. I have had two family members die on hospice and compared to my parents who died in a hospital, there is no question the more humane way to finish a life well lived is to be in an intimate setting with those who care and love you. Not distracted by whirring machines, hoses and wires, necessarily busy and distracting surroundings.

For many, the emotional and physical symptoms and side effects can be more debilitating than the disease itself, so some patients chose to live out their remaining days cognizant, pain-free and able to take comfort in their home and surroundings. So why don’t more patients choose hospice earlier in their disease diagnosis?

If I can offer one thing — especially as so many were caught unprepared by the tragedy we call COVID — have a plan. Talk to your family and physician about advance directives. While you can think calmly about it and not be caught in a crisis; what do YOU want? What do you want your family to know about your care if you are unable to make decisions for yourself?

You can view a video about “Starting the Conversation” at helioscare.org or call our office 607-432-5525 to request an easy to fill out “5 Wishes”, a great tool for anyone interested in planning now for the unexpected.

I look forward to bringing you more columns in the future. Please feel free to reach out to me at dan.ayres@helioscare.org.

Dan Ayres, author, is the President/CEO of Helios Care.