Death is a natural process, a non-negotiable part of the journey called life. Ninety percent of us would prefer to die peacefully at home, surrounded by family and friends, with minimal discomfort. In reality, 75 percent of us will die in some kind of institution, often receiving protracted and costly care, without the comfort and support of loved ones. Hospice, which accepts and honors our mortality, facilitates dying with dignity and grace, manages pain and discomfort, and supports and encourages family members through the process. However, fewer than one in five Americans die in hospice care.
Out, I say! One; two, why then 'tis time to do't. My skin is murky. Okay, probably not exactly how the Bard would have written it, but I would bet it's exactly what Lady Macbeth was trying to say. Men always misinterpret women, why is that?Of course her skin was murky! After 35, even with the best of home care, you have to know when to call in the professionals. Being a diva, I've been taking care of mine since my teens. Years of acne taught me that early! Sadly I spent much of my wasted youth tanning and sun bedding. Remember when those first beds came out? Year round bronze beauty.That's why so many of us look like handbags today. In my case a badly mottled one.
Another factor in the dismal state of end-of-life care is money. Medicare has made across-the-board reimbursement cuts, forcing hospitals to stay viable by decreasing general floor care and promoting excessive use of intensive care units to allow for greater billing. Every year, thousands of patients languish in intensive care units with no chance of recovery. Many have bedsores, decaying digits, and other deforming maladies.
Melasma. Say it loud, say it proud. My face by mid-thirties looked like a shaded relief map of Asia. I won't go into a scientific definition of melasma, but it's a horrid condition of blotchy, brown areas all over your skin. It looks like Guerlain's Terracotta Summer Stones, except not blended or pretty. Melasma apparently loves all things Asian, African, Mediterranean, or Hispanic. Since I am a mixture of two of these groups, I get lots of love from Melasma. Not to say it discriminates
Discount Fendi Sunglasses, it likes white girls too. But you know us brown girls love to show how tan we get, and I could roast and toast with the best of them. Well bully for me because all I have to show for it is my multicolored face.
In addition, fee-for-service payments for physicians and an escalating diagnostic-related groups (DRG) payment system for hospitals mean the more that is done, especially more procedures
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The system is convoluted and extremely complex and open to varied interpretation when it comes to actual billing and payment for services. For example, with our present DRG payment system, if a patient leaves the hospital for another facility
Jordan 4 + Jordan 6 Shoes, including out-of-home hospice, the hospital, depending on the particular situation, may be reimbursed a lesser amount for services rendered during the hospital stay.
Inappropriate care of the dying is one of the most disturbing problems of the expensive U.S. healthcare system. Part of the blame lies with the Patient Self-Determination Act, which created advanced directives and living wills. Quite simply, it does not work because only a fraction of the population has them, and, even when they do exist, many are not followed. It is also absurd to assume that patients and family members with no medical training can imagine future end-of-life situations and plan appropriately.
Consequently, many physicians treating patients in end-of-life situations, especially if there is no advanced directive, assume the patient wants everything possible done and often propose options, some of which they know represent unrealistic goals. Thus, patients and their families, with no medical expertise, become consumers of medical services in much the same ways they are consumers of iPods, handbags and shoes, and the physician becomes a technician following orders. At other times, physicians know there is no chance of recovery, but families or guardians refuse to accept this reality. Physicians and hospitals afraid of legal action continue heroic measures until eventually nature takes its course.
We need a medical profession that the public can trust to protect them from a painfully and financially disastrous end of life, yet our large hospitals provide excessive non-beneficial end-of-life care, thereby teaching principles of aggressive end-of-life care to future generations of doctors. We now spend almost twice as much for healthcare per person than any other industrialized country in the world. If we continue to practice our present style of end-of-life care, the costs to our society will become prohibitive as the baby boom generation reaches age 70 and beyond. Now is the time to begin making meaningful changes before a crisis occurs and the ensuing panic forces unwise decisions and hastily made solutions.