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Letters to the Editor: Does signing up for hospice care guarantee a comfortable death?

Hospice workers hold the hands of a terminally ill patient in Lakewood, Colo., in 2009.
(John Moore / Getty Images)
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To the editor: Thank you for your exposé on hospice care. People are surprised when I tell them that the biggest mistake I made in managing care for my elderly uncle for four years before his death was to sign him up with Vitas Hospice Services.

What we got was inappropriate medication that could have caused his death, and for the most part, total neglect. Fortunately, I continued to take my uncle to the Department of Veterans Affairs for medical care, not disclosing the hospice contract.

Medicare paid Vitas about $5,000 per month, but my uncle received almost no services. My mother is now 97 and near the end of her life. We will have nothing to do with hospice.

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Linda Sapiro Moon, Huntington Beach

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To the editor: After reading your series on negligent hospice care, especially as it applies to Vitas, I felt the need to offer a different experience.

During the last six months of my sister’s battle with Parkinson’s, Vitas stepped in. It made arrangements to let her stay at her assisted-living facility, bringing in a hospital bed and other medical equipment. Vitas nurses checked in on a regular basis and later worked 24-hour shifts toward the end.

The hospice physician was very comforting. Aides regularly bathed and massaged her. The hospice social worker, after learning of her and my sister’s mutual love of an obscure folk singer, brought in recordings so they could listen together.

When it was time for me to say goodbye to my sister, the Vitas nurse had tears in his eyes. He was at her bedside when she died a few hours later.

I will always be grateful for the services Vitas provided, all at no cost to us.

Tim Gregory, Pasadena

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To the editor: I’ve always thought there’s a special heaven for hospice workers. My family is now experiencing this, as my mother recently enrolled in at-home hospice care from a provider recommended by her doctor.

Reading The Times’ investigative report, I now know there’s a special hell for fraudulent “hospice” workers.

Julie Taylor, West Hollywood

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To the editor: Thanks to The Times for bringing to light the problems of hospice care in Los Angeles County. Several stories tell of loved ones pleading on the phone for the hospice nurse to come because their loved one was in excruciating pain. That does not need to happen.

Anyone accepting home hospice understands someone must be present at all times. Each hospice patient’s caregiver is given a “comfort kit” that includes morphine. The caregiver is (or should be) instructed on how to administer the morphine.

When my husband was dying of cancer in our home, I knew it was my responsibility to administer morphine if he needed it. I did not call a nurse to come do it.

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One afternoon my husband was clearly in distress and I gave him a measured dose. His agitation stopped and a few minutes later he died.

There are many problems with the current for-profit hospice system, and one is not clearly communicating the need for the loved one present to be proactive with pain medication as the patient nears the end of their life.

Doug Jones, Los Feliz

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