Happy Birthday, Dad!

Today would have been Dad's 103 birthday.  Raymond Lewis Lockhart, known to all as Pete, was several months younger than I am now when he died –  61 years, 11 months & some days.  Back then, I thought he was an old guy;  now, he seems a baby. 

It gives me comfort, knowing he'd be pleased that Mom died - a long 28 years later - in her own room, in her own home, a caring nurse close by & me at her side, singing her out.

In 1973, Dad died alone, in a nursing home several towns from ours, with staff down the hall. He died in a sterile setting, with only strangers close by.

What a difference a generation makes.  Dad died just before the concept of hospice care was introduced to the United States.  It would be over ten years before hospices were accredited, another ten years after that for them to a guaranteed health care benefit.

Hospice care makes so much sense, but it was resisted – mightily – by insurance providers.  When I worked at US Healthcare & for most of the years I worked at Prudential Healthcare, hospice care wasn’t covered. And that's exactly how my employers hoped to keep things.

Today, it's hard to find online information about the resistance insurance carriers put up to hospice care, but I was there & remember how strongly they fought against providing coverage.  It made no sense, even at the time, but insurance carriers preferred covering mega expensive in-hospital stays to significantly less costly, considerably more humane hospice services.  

People look at me like I am daft, a screw loose, to say that carriers fought hard to keep things just as they were.  But I will never forget the heartbreak of telling members or doctors that health services would be covered ONLY  if a person remained in the hospital, none if they were discharged home for their last months.   How would I have felt with Dad in the tragic twist of hospice care being available, but uncovered?

Praise be, the insurance giants failed.  In 1993, hospice care became a guaranteed benefit.  It had a happy unforeseen consequence, with hospital care becoming more responsive, more patient-centered, practically downright humane.   In 1973, visiting hours were strictly enforced at Dad's nursing home, even in the face of impending death.  By 2001, when Mom was at Inova/Alexandria & later at St. Mary’s, both staffs were remarkably flexible with how early I could arrive, how late I could stay.  

Both my parents died in the wee hours of the morning, but only one was completely alone.  Dad would be relieved knowing Mom passed to him hearing "Till We Meet Again" ~ ~ smile a while & kiss me sad adieu.  My hope is that the number of people who have the blessing of dying as Mom did – in her own room, in her own home – grows even more. 

Over the long years stretching from his death to hers, there was never a doubt in my mind that the best present I could give Dad was to be a loving presence in Mom's life.  I am sure he & Mom join me in giving thanks to Dame Cicely Saunders (what a lovely face - could have been Mom's sister!) for developing the modern concept of hospice care; to Florence Wald, Dean of the Yale School of Nursing, for promoting hospice care in the USA;  to Elisabeth Kubler-Ross, for introducing Americans to the concept of death with dignity;  to Senators Frank Church (D-ID) & Frank Moss (D-UT) for introducing the first hospice legislation (it didn't pass); and to The W.K. Kellogg Foundation for underwriting a study by the Joint Commission on Accreditation of Hospitals (JCAHO) investigating the status of hospice & developing standards for hospice accreditation.  Their combined efforts - against fierce resistance & powerful special interests - resulted in hospice care that makes death with dignity a reality for so many, young & old. My mother thanks you, my father thanks you, and I - most lovingly & gratefully - thank you!