Can We Let Patients Starve Themselves to Death - Even If They Have Dementia - and Can We Get Paid for It? Ethics and Reimbursement at the End of Life

As the incidence of dementia increases there is growing awareness among patients of their ability to make decisions about care including explicit refusal of assisted oral feeding, even while receiving symptom management through hospice or palliative care

Why are clinicians and institutions often reluctant to support a patient's decision to refuse oral feeding, particularly in the presence of dementia? It is often due to misunderstanddings about the CMS definitions of Abuse, Neglect and Immediate Jeopardy

The session will examine regulatory and reimbursement challenges including CMS charges of failure to provide adequate nutrition and hydration to support and maintain life, which providers and institutions must contront with patients who do not want to