Hospice Nurse Reveals the Most Common Deathbed Regrets

Unilad / By Niamh Shackleton

They say that your life flashes before your eyes before you die, so how would you feel watching your life back?

Would you be happy with the way you lived your life, or would you have regrets?

If you think you'd have regrets, you're not alone.

Bronnie Ware, a nurse who has spent a large majority of her career working in palliative care, found that there were five common things that people regretted about their lives upon reflection as they approached death.

'I wish I hadn’t dedicated so much of my life to working so hard'

Bronnie, who was a palliative care nurse for eight years, says many expressed their woes of having spent so much of their lives at work.

Apparently men in particular voiced this regret the most, with many being the 'breadwinner' of their house.

Upon reflection, they wished they had spent more time with their loved ones instead.

'I wish I’d lived my life the way I wanted, not how others expected me to behave'

I'm sure a lot of people will empathize with this one.

Bronnie said that many felt they suppressed their true desires in a bid to keep the people around them happy.

One thing in particular that Bronnie noticed is that people regretted not pursuing their personal dreams.

"The only way we can find peace within is to be true to our own calling, our dream and own nature," she writes in her book, The Top Five Regrets of the Dying – A Life Transformed by the Dearly Departing.

'I regret losing touch with so many of my friends'

As we get older and busier, it's gets harder to maintain friendships. According to a survey published last year, eight percent of responds in the US said they had no close friends in what's being hailed as 'a loneliness epidemic' in America.

But, while it might not seem like it when you've got three kids at home and a busy 9-5 job, friendships are extremely important to achieving a fulfilling life…

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Advocacy Alert – Your Action Needed!

HHAC’s Executive Director, Don Knox, was in our Nation’s Capital last week, visiting elected officials’ offices and advocating for hospice, home health, and home care.

We need your help to support Don's. Please use the links below to NAHC’s Legislative Action Center, to send a message to your Senator and Representative’s offices. These links can also be shared on social media and emailed/text to all your colleagues, friends and family. By entering the zip code of their home address, the pre-crafted or customized message will be sent to the correct elected officials.

Here are the links to each of the campaigns: 

1. https://p2a.co/8IGAgf7 - Home Health cuts
2. https://p2a.co/k7KvFSw - Value of Hospice
3. https://p2a.co/RwhIQmU - Hospice Program Integrity
4. https://p2a.co/QatsGBW - Credit for Caring Act
5. https://p2a.co/Qx35STZ - Direct Support Professionals Act
6. https://p2a.co/yFSMAaO - Medicaid 80/20 Proposal 

If we don’t speak up, we don’t have a voice!

NHPCO and NAHC Issue Update on Certifying Physician Enrollment Requirements

NHPCO Summary at a Glance

May 1, 2024, a new hospice claims edit will be implemented. This edit, associated with the condition of payment finalized in the Fiscal Year (FY) 2024 Hospice Wage Index final rule, requires that the hospice certifying physician(s) be enrolled in Medicare or have a valid opt-out on file. This has raised many questions and concerns about the implementation of the edit from both hospice providers and Electronic Health Record (EHR) companies due to lack of clarity and conflicting information in instructions and guidance.

Two key points for hospices to know at this time are:

• As long as the Attending Physician field on the claim contains the NPI of a physician that is enrolled or validly opted-out, the edit that goes into effect on May 1 will allow the claim to process and be paid.
  
  
• The edit that goes live on May 1 will only verify the physician listed in the Attending Physician field on the claim. On October 7, 2024, a new edit will go live that will verify the physician listed in the Attending Physician field on the claim and the physician listed in the Referring Physician (Other Physician) field on the claim.

NHPCO and NAHC are working on a Frequently Asked Questions document and plan to publish this in the near future. Any questions can be directed to [email protected].

President Biden and Secretary Becerra Discuss Medicaid Access Rule

NAHC Report

Recent comments from leaders within the Executive Branch foreshadow a required passthrough within the Medicaid Access Final rule, which will likely be released before the end of April. On Tuesday, April 9^th, President Joe Biden addressed a gathering of advocates focused on the “care economy,” a term used to encompass the childcare and long-term care workforces. As part of his remarks, the President promised, “in the coming weeks, we plan to release new rules to strengthen staffing standards in nursing homes, to get homecare workers a bigger share of Medicaid payments.”

On Thursday, April 11^th, Secretary Becerra provided additional details on the Medicaid Access Rule, telling a separate group of advocates for care economy workers that the Administration would advance a rule, “that lift the wages of homecare workers, because what it will do, it will say every time we make a payment to whoever is getting the money to do the service, 80% of it has to go to the worker. 80%. No more of this, ‘well, we have a high overhead,’ or we had to increase our executive wage. No, 80% of dollars paid out must be focused on the workers.”

The remarks from these leaders refer to the Medicaid Access Rule, which was initially proposed in May 2023 and contains a provision that would mandate 80% of all Medicaid payments for homemaker, home health aide, and personal care services be paid as compensation to direct care workers. While well intentioned, the rule does not account for the various regulatory and statutory requirements associated with delivering these services, such as nurse supervision, electronic visit verification, travel mileage reimbursement, or other necessary expenses. Additionally, the rule would place a significant burden of monitoring and enforcing the requirements on state governments. For these reasons, States from all political leanings expressed significant concerns with the provision.

The Medicaid Access Rule is currently at the Office of Management and Budget for review, which is the final clearance step before rules are released. The Final Rule is expected before the end of April.

Becerra Remarks: https://www.youtube.com/watch?v=DjIDu1C5UP8

Biden Transcript: https://www.whitehouse.gov/briefing-room/speeches-remarks/2024/04/09/remarks-by-president-biden-on-the-care-economy-washington-d-c/