End Of Life Care : What Is Too Much Pay And Who Pays

Medicare will pay for some of the cost for 100 days. First 20 days they pay the full amount and from 21 days to 100 the individual pays $140 of expenses.

Hospice—Two caps 1) Number of days of inpatient care are furnished is limited to not more than 20 percent of total patient care days, *The Inpatient Cap*. 2) Aggregate payment amount received in Medicare payments for services provided in the cap year is limited to the cap amount times the number of Medicare patients served, *Aggregate Cap*. There are two different methods for counting the number of Medicare patients; Proportional Method and Streamlined Method.

The purpose of this paper is to examine communication strategies related to palliative and end-of-life care with a focus on Aboriginal clients. Firstly, I will explain the role of cultural competence in the nursing care of an Aboriginal client. Secondly, I will argue the cultural challenges a nurse may face when caring and communicating with Aboriginal clients receiving palliative end-of-life care. Thirdly, I will present solutions to the aforementioned communicative challenges. Lastly, I will discuss the impact I believe this experience may have on my future practice.

claims per year. In 2008, Medicare accounted for 13% ($386 billion) of the federal budget. In 2010, it is

18). This type of spending is not surprising since there are such outstanding research and care facilities in this country. It is important to note, though, that of these expenditures, $50 billion of Medicare expenses are paid during the final two months of patients’ lives (CBS News, 2010). While it is important to provide excellent care during the final days of a patient’s life, many of these costs are for medical technology that does not really extend either the quantity or quality of a person’s life.

For many people, the process of dying is a prolonged, painful, and emotionally devastating experience. Dying often leaves an individual filled with fear, confusion, and feelings of loneliness and isolation. Fortunately, there are palliative care options that seek to mitigate not only the physical pains and symptoms of death, but also actively work to address the emotional turmoil countless people experience as they begin to descend towards death. On the other hand, far too many Americans still die in intensive-care-units and emergency rooms, where doctors aggressively work to save the lives of all patients, without regarding the actual status or well-being of the person’s life before them. Dying in a hospital room is not peaceful; it is often

My perceptions have changed dramatically since the Clinical 1 rotation. I have noticed that the minute I walk into my patient’s room, I start to collect data. I notice if they are breathing normal, what their skin looks like, what their cognition level is, and what equipment they have in their room. I have started to connect the “puzzle pieces” of the patient’s health, rather than just feeling like I have a bunch of random information. My perception of people has continued to stay the same from Clinical 1. I continue to have an interest in learning about patients and believe that they also have something to teach us. I have learned so much from the patients and it is fun for me to get to know different

Terminally ill patients, like Brittany Maynard, who sit in hospitals for the rest of their days often feel their liabilities hovering over them. The main issue these patients struggle with is having their family pay all the hospital bills. Patients often realize that when they die, their

Death is one of the most significant life events people experience. Most people want to die a peaceful death and desire the same outcome for their family and friends. Medical advancements have resulted in people living longer lives with chronic illnesses. Despite the advancements in medicine and the available treatments of today, sometimes the patient is still unable to escape intolerable suffering; the patient’s quality of life diminishes.

The average per day fee in 2010 was $219.00. Compiling a fee schedule from a few facilities in my immediate area I was able to determine that this fee has increased since 2010 with the average daily fee being $266.00 There is 100 day cap on the any one stay after which Medicare will no longer pay and the patient will become financially responsible. By the year 2030 “The population aged 65 and older is predicted to double from around 38 million to 71 million, according to estimates by the U.S Census Bureau.”(Bezaitis, 2009) This resonates volumes today as it touches on the prediction of shortages in the workforce of SNFs if Medicare budgets were to be cut; predicting that the shortages would be viable on all levels of long-term care. “About 5.7 million to 6.5 million long-term care workers such as nurses, nurses’ aides and home health and personal care workers, will be needed by 2050.” (Bezaitis, 2009) The pending cuts will without a doubt create a domino effect throughout the long-term care industry; a drastic cut in funding creates a need to adjust operating budgets thus affecting employment

Why don’t health insurance groups and companies give better health rewards to patients who are willing to set up a basic end-of-life medical care? When a patient receives a diagnosis, it’s hard to believe that the health care companies are hard to afford due to helping people in need to save their health and pay off different types of surgeries and for patients willing to skip this type of health policy . It also depends on the different payments to receive different

There are occasions when medicine is not your friend and the effects of the treatment will only prolong the suffering of the patient. Healthcare professionals must be objective and ask will the end result be changed. We must know when it is appropriate to discuss end of life options and when it is not. According to Adams (2015), most desire to die at home, but less than half are allowed to do so (p. 13). Our responsibility is to allow the client to make an educated decision about all the available service and treatments.

For hospitals, the predominant unit of payment for inpatient care is often a per day basis. The hospital receives a fixed daily payment rate per enrollee patient regardless of the services provided. However, it can have mixed option in the hospitals including pay a per diem rate for all inpatient services, as well as case rate pay for DRGs; most often high costed surgeries get paid by case basis rate. Under this case based arrangement, providers must take into consideration outlier and inlier cases. These cases can be reimbursed on a percentage of

Many may see the hospital as their only option, but there is still always Hospice care. Hospice care is paid for through the Medicare Hospice Benefit, which fully covers most patients in its service. The hospice also pays for all medical services, medications, durable medical equipment, supplies and treatments related to managing patients’ serious illness and approved as part of their individual plan of care. The hospice plan of care focuses on comfort, rather than curative, measures. Of course many people do not have insurance or are ineligible to receive care through Medicare or Medicaid, but the Hospice has a program for that called Fee Reduction Program:

I do agree with the position of the physician who was interviewed in the segment. I am an ER trauma/ICU nurse. I see patients everyday whose families want extraordinary measures taken to save their family members life, when in actuality they are prolonging their suffering. I am most certainly an advocator for doing everything you can for someone who may have a successful outcome. For example, a healthy 35 year old who was in a motor vehicle accident by all means do everything, use every resource, but when it comes to an 85 year old with terminal cancer, I don’t feel monumental measures should be taken. Another example might be a 92 year old woman who is a full code the healthcare team does compressions, intubates, put in an arterial line, central line, and put her on several Cardiac drips, for what? If she wakes up at all, she will wake up with a tube down her throat, probably a few broken ribs, possibility pneumonia or a hypoxic brain injury, and in tremendous pain, only to pass away a few months later, when she could have gone peacefully and without suffering. I have seen this