We now have curtains and inside trim.
And that’s going to be it until the weekend at the earliest. It’s raining today. It’s supposed rain tomorrow. In fact, it’s supposed to rain the rest of the week. So perhaps this weekend we will take care of the outside stuff.
Or perhaps not.
We came home last night to the following message on our answering machine:
“Hey, I got the wrong number, sorry, but what a great message!”
I had to listen to the message, because I had no idea what message I’d done. Oddly enough, I thought the message on the cell phone voice mail was more amusing, but as long as I’m making people happy…
One of the reasons I have not been writing a great deal recently, is because I have been working on the paper due in my health policy class. It is a group paper, and the subject is, unsurprisingly, End-of-Life Care Policy, with my portion of the paper/project focused upon hospice.
What I find so disturbing about all this is not that the US lacks a cohesive end of life care policy, because that isn’t it. Yes, there are issues such as euthanasia that have yet to be resolved, but that is only a minor issue in the grand scheme of end-of-life care. What surprise me is that despite the existence of relatively strong policy, so very little has been achieved.
In the United States, hospice is covered by most private insurance companies, as well as by Medicare Part A. The Medicare Hospice Benefit is quite generous, and one assume (perhaps incorrectly I admit) that private insurance coverage would be similar. For instance, Medicare covers: doctor services, nursing care, medical equipment and supplies, drugs for symptom control and pain relief, short-term hospital care including respite care, home health aides and homemaker services, and grief and loss counseling for both the patient and the family. The Medicare hospice benefit was created to make things as easy for patients and their families as possible. Patients pay no more than $5 for their prescription drugs, and 5% of the cost of any respite care they receive.
So, you’re thinking, the benefit is too generous and costly, and that’s why it is under-used! You would be wrong.
Palliative care (emphasized by hospice) can can improve patient quality of life, and decrease costs. In one study palliative care decreased the number of days in intensive care by 75%. Nationally, in 1998 hospital inpatient charges were an average of $2177 per day, while hospice cost only and average of $113 per day. This means that Medicare not only improves the quality of life for dying patients, but reduces the cost of medical treatment. A win-win situation.
Despite this, hospice utilization remains low. Nationally, the average for the year 2000 was 48 days of hospice use per patient; the average in West Virginia was 52 days of hospice use per patient. Although patients are best served by a longer time in hospice, 79.6% of those who enroll in hospice used only one benefit period.
Hospice and palliative care increase patient quality of life, as well as decrease medical costs, yet it is under-utilized. Why is this?
The prime reason, in my opinion, comes down to how people feel about, and deal with, death.
In my personal experience, when a family member was diagnosed with cancer several years ago, despite urging, they did not want to discuss end-of-life care options, or what they wanted to happen to their body if they were to die. Luckily this turned out not to be an issue, as the treatment went well, but I think it does illustrate a common problem in the US, which is a seeming inability to deal rationally with death and age.
We in the US, as a society, glorify youth, health, and beauty, and try our best to ignore or hide signs of aging, illness, and death. Glance through magazines and catalogs. The models are nearly universally young, thin, and attractive. (However two exceptions to this rule are Land’s End and Gardener’s Supply. Both catalogs use older models.) Look at ads–it seems as if every pharmaceutical company out there is advertising products to make you act and feel younger. Not that I blame the companies really, I mean, if beautiful blondes sell product, then so be it, but have we as a society fallen for it hook, line, and sinker?
This is an issue, and one that is going to become increasingly more important as the baby boom generation retires and starts to realize that no, they will not be young forever.
The other realization, and one that deals with the topic at hand, is that few want to admit they are going to die, and hospice is a tacit statement that death will come, and it will come faster than we want. Yet denying that truth does not make it go away, it only makes the end and the passing harder to bear.
WV Center for End-of-Life Care
Hospice Association of America
Hospice Foundation of America
National Hospice and Palliative Care Organization
Centers for Medicare and Medicaid Services
AgingStats.gov
Went to check my horoscope today, and read this:
Cancer (June 21 – July 22)
You might consider picking up some holy water and a few stout wooden stakes. They’ll come in handy soon, although I’m not sure how.
I laughed, and then read this to Gina, who sits right next to me.
Gina also laughed, and then asked, “Hey! What’s mine?”
Gemini (May 21 – June 20)
Your incisors will seem to be getting longer today, and you will find sunlight hurts your eyes. Probably just a cold, and nothing to worry about.
Oh. I see.
Photos of replacing the kitchen doors. Plus comments.
Pictures of our travels.
Pictures of the work we did to be guest bedroom.
Pictures of replacing the hood over the stove.
We took three bags of books to The Bookshelf last night. Came home with half a bag that he didn’t need, so if anyone is interested, the following books are available, free to a good home. Sorry there is not any Fantasy/Science Fiction, but Jim always takes anything in that category, as well as any mysteries.
Andrew M. Greely:
Ascent into Hell
Virgin and Martyr
Lord of the Dance
They Brother’s Wife
The Cardinal Sins
(these were all purchased used, so their condition isn’t terrific, but they are still readable)
John Grisham:
The Firm
The Client
The Pelican Brief
Ken Follet:
A Dangerous Fortune
Lie Down with Lions
Frederick Forsyth:
The Devil’s Alternative
WVU’s Riflery team will, as of July 2004, be reinstated as an athletic team.
It took a $100,000 grant from the state legislature, but Hardesty finally got the point.
It never made any sense to me why the programs that were chosen were cut. Riflery is for men and women, which makes it a good Title IX sport, and it’s also a sport that has much to do with the history of the state. I mean, our school mascot even carries a rifle!
But, what was done can be undone, and so riflery, much to the consternation of Hardesty, has been reinstated.
May more national championships ensue!
To celebrate/mourn the fact that Michael and I finally finished watching Deep Space Nine, here is a list of some of my favorite Garak quotes, starting with:
“I believe in coincidence. Coincidences happen every day. But I don’t trust coincidences.”
Once I left the windowless room where I work, I realized that it was absolutely beautiful outside. Days like this make the lab a blessing and a curse, I don’t know how beautiful the weather is to enjoy it, but I also know how beautiful the weather is, so I don’t feel trapped inside.
Came home and opened the windows on the storm doors, and then grabbed my pruners and went to look at my plant life. Cut off a bunch of dead wood on a variety of plants, and closely inspected everything else.
It looks as if neither of the roses we planted at the end of the summer made it through the winter, and I’m not sure about the Wiegalia at the bottom of the hill, but almost everything else had buds. How exciting! Things are growing! There will soon be leaves!
Bulbs are coming up all over the place. I saw, besides the crocuses that are already blooming, daffodils that look as if they may flower soon, and the start of tulips and hyacinths. I also saw green growth where the bleeding heart comes up, as well as under the dead leaves of the mums, day lilies, and the hydrangea.
The only damper on the green ecstasy was that when I raked the last of the leaves from the front, it looks as if, despite the fact that we’ve seeded it for the past two years, anything other than spotty patches of grass are not going to happen.
It’s not that I care that much about grass, it’s just that I don’t know what else to attempt to grow there. It’s deep shade, and even deep shade grass didn’t seem to take, nor have any of the shade flowers and plants done well.
Ah well, I have another spring and summer to try and find something to grow there, so it’s not all bad.
Happy spring!
… is the best.
Dr. Minger’s office sent us flowers in momory of Slate.
That’s really above and beyond the call of duty.
Well, not really, but it amused me to squoosh together the titles of the two books I’ve finished recently (assuming that by recently you accept “in the past month or so”)
Woe is I: The Grammarphobe’s Guide to Better English in Plain English by Patricia T. O’Conner
I picked this book up several years ago, but had not gotten very far in it, for as much as I wanted to improve my writing, I was not necessarily interested in reading about improving my writing, but since I am taking a course on editing, I decided that this would be a good book to read.
The Sandman Book of Dreams Neil Gaiman and Ed Kramer, editors
It took me several months to read this book, not because it was boring, but because I was carrying it back and forth to work to read at lunch, or if I had to go somewhere for an appointment. This means that as I finished the last story in the book, I could barely remember the first story in the book.
And while I’m thinking about it, when we were in DC, we made (of course) a bookstore stop, and I found a collection of Gypsy folktales. I haven’t had a chance to really look into it yet, but it sounded great.
Friday is the last day to vote for the WV state quarter!
If we don’t do our civic duty to vote, we as a state may be stuck with the horrible “Appalachian Warmth” quarter.
Remember, this is for posterity, so be honest.
It was Tiddly POM! Thanks Epacris!
This was Piglet’s song
(Tiddly Pom)
The more it goes
(Tiddly Pom)
The more it goes
(Tiddly Pom)
On snowing.
And nobody knows
(Tiddly Pom)
How cold my toes
(Tiddly Pom)
How cold my toes
(Tiddly Pom)
Are growing.
The more it snows
(Tiddly Pom)
The more it goes
(Tiddly Pom)
The more it goes
(Tiddly Pom)
On snowing.
And nobody knows
(Tiddly Pom)
How gold my toes
(Tiddly Pom)
How cold my toes
(Tiddly Pom)
Are growing.
–A.A. Milne
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