"Doctors are poor prognosticators," that’s the opinion of a medical director at a Brevard County (FL.) Hospice But, rather than underestimate, doctors tend to overestimate how long patients with end of-life illnesses will live, remembering that one person does well, and, optimistically, hoping others will, too.

Hospice patients generally are .not expected to live more than six months, although estimates nationally suggest about 8 percent live beyond one year, and some live well beyond an arbitrary deadline. One reason, for this has to do with the shift in the type of patients they see - making definitive predictions about patients' expected life spans much tougher for doctors and hospice teams than in the past, and also requiring "rolling six-month evaluations" to satisfy Medicare criteria for coverage.

Hospices are finding far more patients today with diseases that are chronic and not immediately life threatening. Even cancer patients, who once dominated hospice, "can live with cancer so much longer than before," she said.

A good example of this is humorist Art Buchwald, who was discharged from hospice this last July. Doctors say his nearly non-working kidneys should have killed him long ago. Buchwald, 80, had refused dialysis after doctors amputated his leg below the knee in February.

Twenty years ago, they didn't have the chemotherapy or radiation treatments available they have now, and people were unaware of lifestyle choices that could affect the course of their disease. When hospice first took hold in the United States in the early 1980s, cancer patients' made up roughly 70 percent to 80 percent of those needing palliative care.

Recent data from the National Hospice and Palliative Care Organization, in Alexandria, Va., show cancer patients account for 46 percent of hospice, with non cancer diagnoses making up the rest. According to the hospice organization, the top non cancer diagnoses in the nation's 3,650 hospice programs in 2004 were: end stage heart disease; dementia; debility; and end-stage lung or kidney disease. Adapted from FLORIDA TODAY

A number of CI Members have enquired about hospice care near the CI facility. We have not had CI Members coming to Michigan and using a hospice facility. In the case of Marta Sandberg's husband an apartment was rented and hospice care was given there. The other local cases of hospice care given to CI Members prior to pronouncement and cryopreservation were to Michigan CI Members who had their homes declared a hospice. In such situations if a medical professional is not on hand for pronouncement of death at the time of legal death it is necessary to phone 911 or otherwise swiftly obtain a nurse, MD, EMT or paramedic.The only hospice organization within ten miles of the CI Facility is:

Saint John Hospice

27650 Garfield Rd

Clinton Township, MI 48036-2055

But this organization does not have their own facility. They work out of homes and nursing homes. The only nearby nursing home that actually has a hospice unit is Bortz Health Care of Warren, located in Warren, MI about 11 miles from the CI Facility:

Most nursing homes will provide for hospice care, despite not having a unit specifically dedicated to hospice care. I phoned Saint John Hospice and they suggested a nursing home which is located within two miles of the CI Facility, called Lakepointe Villa: and another nursing home within 7 miles of the CI Facility called Clinton-Aire Healthcare Center:

All three of the aforementioned facilities are designated "religious nonmedical healthcare institutions", the meaning and implication of which are uncertain to me.

If a patient is declared to have less than six months to live, then Medicare will pay for hospice care (nursing and medications), but will not pay for room and board. So there must be funds or other insurance to pay these costs if a nursing home is to be used for the hospice care.

Various CI Members have spoken of creating a dedicated facility for nursing and hospice care near CI, but this will not likely happen until the demand for such a facility is much greater than is presently the case or else someone is willing to underwrite the considerable expense.