concurrent care why it matters

Friday, March 02, 2007

Concurrent Care – why it matters

When I wrote the post about the ten Senators who are pushing for “concurrent care”, I really didn’t think much about it. First, I don’t see anything coming from this push and second, I wasn’t really sure exactly how much good concurrent care would do. I still don’t believe there is much of a chance that President Bush is going to get comprehensive health care reform done in the next two years, but I have had a bit of an eye opening moment when it comes to the importance of concurrent care.

The anniversary of my father’s death has once again come and gone. As usual I was surprised by how hard that anniversary is as I went through the emotions and memories that I would rather forget. Part of that memory is that of being the one person in the room who was clueless. I believe I have told the story before on this blog, but I’ll give the readers digest version here.

My father was in his late 50s and fighting his second bout with lung cancer. He was receiving experimental treatments from MD Anderson Cancer Center. The experimental chemo he was on had, as most chemo does, reduced his immune system to nothing, and he got some kind of bug. He went to work one morning, started feeling sick, left work at noon, went to the hospital the next day, and died the day after that.

Now, you would think that being a “hospice guy” would have clued me into the fact that experimental chemo means things are not going well. As I look back, everything about my fathers condition spells bad news, but I didn’t see any of it. When I got the call that night, I drove 100 mile per hour to the hospital, rushed to his bedside, and even after seeing his dead body was unable to compute that he was dead. Everyone assumed that I was smart enough to have put two and two together, so nobody had actually said, “your father is dead”. I stood there for a few minutes before I figured it out. Him being dead just wasn’t on my list of possibilities.

Again, I do this for a living, so if I couldn’t see what was coming, then how in the world are those outside of the medical community expected to be prepared for what is coming?

While running that horrible night through my head the light came on as to why concurrent care is important. My father had a terminal illness. Without a miracle, he was going to die of cancer. He was also not about to stop treatment. In the months before his death he had seen the birth of two grandchildren and the engagement of his daughter. He was going to do anything to be at the wedding and see the next set of grandchildren. Because he had that kind of mentality and motivation, nobody had ever really talked to us about the reality of his prognosis. He and mom didn’t have the emotional support that they probably needed. There was never a clear sign from the medical community that there was a chance that the outcome was going to be anything but positive. Sure, anyone with half a brain could see the writing on the wall, but few people who are facing their death or the death of someone they love can be accused of having half a brain.

My family would have benefited from “concurrent care”. I would have benefited emotionally from dad having concurrent care. If a hospice could have come alongside the experts at MD Anderson (and God bless them all) dad’s final months would have been better and our family would have been more prepared for what was to come. Dad’s pain was not under control near the end. He sure didn’t feel good! He could have used help, but none was there because he was taking experimental drugs. What a shame!

I have become a believer in concurrent care. Yes, there is a great chance that the system would be abused. No, I’m not sure how to institute this idea without opening the system to abuse, but it is time to start finding those answers. There are people in every community today who are fighting. They will never quit fighting. Does that mean they are going to win? No. A system that tells them that they can either fight or be comfortable is near inhumane. It is time for a change. If you don’t believe me, the hospice guy, then believe the son who watched his father fight a battle he didn’t have a chance to win while never knowing that losing was even an option.

If I can help one person avoid what happened to me in that hospital room, then my life’s work will have been worth it all.



I agree with your ideas about “concurrent care.” Recently I (a hospice RN) took care of my mother, who was on hospice for 10 days. I also helped with my sister’s care the day she died, but she was not on hospice because, like your father, she was still taking chemo. I wish that there was bereavement support available to her family.