It is usually defined as a process that determines which problems are most prominent; it may be formal or informal and may be completed by relatives or professionals. From this assessment, a plan of care is developed to address and alleviate those problems. (1) When the dying accept hospice care they give up curative treatment. Instead hospice helps them to live out their final days alert and pain free. Early hospices represented a revolt against traditional medicine, which is seen as failing the terminally ill by giving them futile, but aggressive treatment. If someone was dying, a hospice volunteer went to the person’s home to do whatever is need, from emptying catheters to providing companionship. When hospices started in the mid-1970, no one was billed for these services. Funding came from charitable contributions. The hospice of the Florida Suncoast was started in 1975 by volunteers, who worked from a one-bedroom house with donated wheelchairs and walkers stacked in a bathtub.
In 1983 Medicare began to reimburse for hospice care, allowing hospices to serve far more people. Medicare fundsfueled a fourfold increase in patients served, from around 100,000 in 1983 to nearly 400,000 today. The Medicaid reimbursement enabled hospices to offer more sophisticated care that included skilled nursing and physical therapy. And it seemed like a goodbet for taxpayers. For every dollar spent on hospice patients in the last year of life, Medicare saves 1.52. But the savings are less certain after six months of