THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, December 3, 1995 TAG: 9512020186
SECTION: CHESAPEAKE CLIPPER PAGE: 02 EDITION: FINAL
COLUMN: Random Rambles
SOURCE: Tony Stein
LENGTH: Medium: 82 lines
There was an unhappy story in the paper a few days ago. It said that millions of dying patients suffer needless pain because the medical profession keeps trying to prolong their lives rather than letting them die in peace.
But there is another way. It's called hospice, and Chesapeake General has joined a growing list of hospitals offering the program. Its goal is to make that last journey as pain-free as possible in familiar surroundings with friends and family close at hand.
A hospice was a place of rest for travelers in the Middle Ages. That sense of peace and rest is the heart of hospice today. The premise is simple, yet dramatic. It is revolutionary in today's world of high-tech medicine, yet a return to the ways of yesterday. At its center is a terminally ill patient with six months or less to live. Under a hospice program like the one at Chesapeake General, there are no all-out battles to provide just a few more hours or days. Instead, the patient is kept as comfortable as possible physically and emotionally. Death is neither postponed or hastened. It is simply awaited.
Some hospice programs are housed in hospitals but Chesapeake General Hospital's hospice plan deals with the patient at home. A team of professionals instructs, advises and supports the caregivers. There can be volunteers as well, people who can give the caregivers occasional respites from what can be a stressful vigil.
In its home-centered approach, Chesapeake General's hospice is a return to earlier times, says Louise Ross. She's the registered nurse who coordinates the hospice. Up until the 1940s, she says, people usually died at home. They were, in the phrase of the times, ``laid out'' in the parlor. That's why funeral homes used to be called funeral parlors.
And, Ross says, because so many Americans were farmers, there was more of a realization that life is a cycle. Just as the crops in the field had their cycle of planting, growth and harvest; just as the seasons had their cycle of spring and summer and fall and winter.
``Death was closer in those days,'' Ross says. ``Then we moved from that closeness. We put the hospital and the technology and the doctors and the nurses in between. We don't want to talk about death, either. If a dying person wants to talk about it, we often cut them off with some kind of cheerful comment.
``But it's important for a dying person to be able to say things and deal with things. Maybe there's a relationship that needs to be mended or personal business that needs to be settled or just something that the patient wants to say. The critical need is for people to have a sense of closure about their lives.''
A hospice situation sets the kind of a tone that allows closure, Ross says. ``No matter how nice a hospital is, it is still an alien place. Hospice lets the family and the patient spend some very precious time together.''
Doctors, with the agreement of the patient and the patient's family, recommend entry into the hospice program. The patient has to accept death and not request any more aggressive treatment. Then a hospice representative assesses the situation and works with the family to provide whatever service is needed. The professional team includes doctors, nurses, therapists, social workers and clergymen. Cost of the hospice program varies with individual cases, but Ross says many insurance programs will cover it.
One major goal is to keep the patient as pain-free as possible, though still able to respond and share moments with the family. ``The idea is to take each day and make it the best it can be,'' Ross says.
A friend of mine died last year in the hospice unit at the veterans hospital in Hampton. He had no immediate family so members of my church, the Unitarian Church of Norfolk, became his family. The hospice staff provided the medical care, but church members were Jack's support group. Visiting with him meant sharing all the things he wanted to say about his life and his death. There was no pretense, simply the quietly sad acceptance that he was on a last journey.
He kept his own schedule, and until the weather turned chilly he loved to sit out front and watch the ships and boats crisscross Hampton Roads. One of the things we learned about him was that he had once been a yacht captain and that his happiest days had been spent on the ocean.
There was a church member with him when he died one night at 1 a.m. He was not in pain. He was not alone. He had experienced closure. His last days had been the best they could be. That's what hospice is about. by CNB