A hospital denied to treat for pneumonia because the patient was admitted under hospice care.

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My friend's mom who has AD went to the hospital because she aspirated a piece of food. She was physically very healthy. Doctor at the hospital told family they wouldn't treat for pneumonia because she was admitted under hospice. We tried to cancel hospice in order to receive antibiotics and were told we couldn't. Doctor told us if we wanted antibiotics we would have to pay for the medications and the hospital stay out of pocket. He discharged her after several hours basically to die. All she needed was a course of antibiotics and to have the phlegm suctioned out of her throat. Was this legal???

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Dranny, my Dad recently passed having aspiration pneumonia. Normally when food/liquids are given, the person is able to swallow the food/liquids and it automatically goes into the stomach.

With aspiration, some of the food/liquids go into the lungs because the swallowing part of our body becomes very narrow.... harmful bacteria develop, thus pneumonia will happen.

My Dad had antibiotics and suction done, but the hospital highly recommended my Dad be placed on Hospice. There was no cure for his aspiration situation. And please note, with dementia, the patient can forget how to swallow.

Plus Dad had a Medical Directive that instructed no food tubes, etc. A couple weeks later he passed.
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There was a miscommunication here and your friend's family needs to talk to the hospice team. A patient can be taken off of hospice at any time - you just tell the hospice doctor that the patient must go off hospice so the doctor at the hospital can treat the patient; Medicare rules dictate that paperwork must be signed off by the patient/patient's family acknowledging that the patient is no longer receiving hospice coverage ("letting nature take it's course") in order to receive medical treatment for a "cure", then Medicare will have no problem paying the doctor, the hospital, etc for a curative treatment, such as antibiotics or a hospital visit stay. It can get a little confusing for patient's/patient's family when they are first exposed to "hospice" benefits. Medicare has multiple areas of  coverage; one being "regular" or "primary" coverage like going to the hospital for pneumonia or going to a doctor's office for annual visit; second is "hospice coverage", where the patient is not receiving curative treatment but is eligible for symptom relief. If the patient was denied by the hospice administrator of getting off hospice - and it's in the patient's records - then there's grounds for an investigation - but I wouldn't go down that road right now because the patient's family is under the stress from the loss. The doctor at the hospital is not the one at fault here as he was just following Medicare rules (my experience is only with Medicare) and patient was classified under the "hospice" category of Medicare; the doctor will treat but under the hospice category the patient is responsible for payment. In your friend's case, under hospice care her loved one would have receive pain relief or a nebulizer (to break up the phlegm) or a suction machine to catch the phlegm, for example, as her body takes it's natural course in fighting the infection. After your friend's family has dealt with the loss of their loved one, then they should talk to the hospice team to learn what was the miscommunication. Right now there's too much anger and sadness to thoughtfully think things though.
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I'm in agreement with the previous posts and want to expand upon it a little bit - the hospice factor.

Because hospice treatment can be sticky business - allowing someone to die without much or any medical intervention - even in cases when antibiotics might prolong life - there are guidelines and rules governing hospice treatment. These rules are mandated by our government.

To start - for someone to be accepted into hospice it is required that a doctor determine that the patient has six months or less to live. This isn't a perfect science - as we know but within that determination there is again, criteria that must be met. Beyond a diagnosis of a terminal illness - is the patient losing weight - and just not a pound or two? How much time does the patient spend sleeping? How rapidly is the patients quality of life declining? Blood pressure, oxygen saturation levels, ability to swallow etc. If a patient meets the required criteria they can be placed in hospice care. If a patient ceases to meet the criteria on a consistent basis - they are usually taken off hospice.

Unfortunately, it's become a bit of an urban legend that you can just sign your parent up for hospice and they'll help you speed along death. Its just not that simple.  Remember- government is involved - and that ALWAYS makes things a bit harder. 

Often hospice will treat things like a UTI with antibiotics- it's considered a comfort issue. However, if the patient has an Advanced Directive stating wishes to the contrary regarding end of life measures - hospice will honor that. 

As the other replies have stated - there was very likely more going on in the health and care of this lady than is readily apparent. 
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Great answers above. If she aspirated how did she get to the hospital, 911 or did the family bring her? If someone aspirated a piece of food she may need the Heimlick procedure? That is quite an acute situation.
Yes get all the facts so you can help your friend through this.
I took care of a hospice patient that probably had aspiration pneumonia. The Hospice doctor, when notified, prescribed oral antibiotics which cleared things up a bit but he has pulmonary fibrosis and upper respiratory infections are common.
"Physically very healthy" does not describe a Hospice patient.
I am sorry you and your friend are going through this.
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This is a very sad situation and clearly there are some facts missing. hospitals don't refuse to treat patients because they are in Hospice. You are free to leave Hospice at any time no one can stop you. Hospice may refuse to cover acute care in a hospital and in this case the cost has to be borne out of pocket which is obviously very expensive unless there is other insurance available. It is common practice for hospice not to treat infections at the end of life but the primary caregiver and patient if capable are given the choice. Hospice willoften admit a patient to hospital for the treatment of an acute condition if the patient is not yet close to death and it will improve the quality of life. Don't blame the hospital till you understand the facts. One of the stages of grieving is anger and trying to find some one to blame and this may be what your friend is experiencing.
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Also, people who are physically "very healthy" don't get admitted to hospice. Letting nature take it's course is the whole idea behind it, admitting that someone has very little time left (generally 6 months, but it varies) and allowing them to die without prolonging physical and mental pain and suffering.
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A person who is "physically very healthy" would not have been accepted for hospice care and would not have had the impaired swallowing reflexes that lead to aspiration and aspiration pneumonia. So, there was something else important going on. If you can find out what that was, then you'll have the explanation of why her care plan followed this path. You might also want to check that the hospital wasn't following an advance directive. Who was acting as your friend's mother's advocate or health care proxy? Where was the mother being cared for prior to her hospital admission?

I'm sorry that your friend lost her mother in this way. It must be very upsetting for her anyway; but you can help her more by clarifying what really happened along the whole chain of events, than by encouraging her to believe that the hospital intentionally killed her mother who otherwise would have returned to a healthy, happy life.
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Are you sure you have all the facts?

Aspiration pneumonia is serious business and is often not so easy as a course of antibiotics.
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