A*******s
发帖数: 9638 | 1 周末被一个医生朋友提勒（di le）到了医院， 因为他的一个病人被送进了ICU。 她是
一个hospice病人， 突发cardiac arrest， 家属不光自己做CPR， 居然还打了911，结
果她最终被送到ICU.
家属对医院的消极态度极其不满， 她儿子气愤的告诉我说， ER的staff埋怨家属不应
该打911， 所以现在他们拒绝extubate， 即使几个医生都说病人回生无望。
我纳闷啊，这个病人不是在hospice吗？ 怎么hospice病人没有DNR就让她进program了
呢？ 这可是federal funded program， 不用病人掏钱的啊。 后来了解到州与州的规
定不同， 我们州是允许的。
理论上所有的code status都是可以改变的， 但一般来说，改变应该有理由吧， 比方
说病情有变化。 一直是DNR， 到了垂死时刻， 家属突然良心发现， 要full code，
这个可以有， 但不能经常有吧？
Hospice病人可以full code我是不理解， 如果家属自己掏腰包， 我没意见， 可事实
上他们一方面让federal支付hospice的费用， 另一方面，又要享受非hospice病人的待
遇， 这个漏洞让人无法接受。
大家说呢？ | u*******l
发帖数: 107 | 2 "Hospice病人可以full code我是不理解". I have seen a lot of patient on
Hospice getting all kinds of comfort care, including pain meds, but are full
code. Here, terminal cancer patients can be on hospice and getting
palliative chemotherapy, regular lab and imaging.
"Hospice is federal funded program? " At my area, we have city /county
funded medical insurance pay Hospice program.
I DO believe the huge expense of medical care in the US is partly due to the
fact that the patient/family doNOT 自己掏腰包. | A*******s
发帖数: 9638 | 3 In FL， you have to be DNR in order to qualify hospice program, according to
a social worker. This really makes sense. Hospice is a totally free program
. Compare to NH or other senile programs, you can keep your money for your
kids if you are in hospice. Otherwise, you have to exhaust your personal
funds before Government starts to pay for your NH or other programs.
That's why there is a limitation of gift amount per year you can give to
your relatives.
full
the
【在 u*******l 的大作中提到】
: "Hospice病人可以full code我是不理解". I have seen a lot of patient on
: Hospice getting all kinds of comfort care, including pain meds, but are full
: code. Here, terminal cancer patients can be on hospice and getting
: palliative chemotherapy, regular lab and imaging.
: "Hospice is federal funded program? " At my area, we have city /county
: funded medical insurance pay Hospice program.
: I DO believe the huge expense of medical care in the US is partly due to the
: fact that the patient/family doNOT 自己掏腰包.
| s**********t
发帖数: 217 | 4 It happens all the time. The family just wants to take advantage from the
hospice program. On the other hand, you should have a good palliative care
team and hospice team. The patient's family should know that they should
call hospice nurse in stead of 911 when they have question or trouble. The
hospice nurse should be 24/7 available. | o**********e
发帖数: 18403 | 5 atul gawande wrote about hospice care here:
http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gaw
certainly there's a different perspective |
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