THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, November 26, 1995 TAG: 9511230021
SECTION: COMMENTARY PAGE: J4 EDITION: FINAL
TYPE: Opinion
SOURCE: By MICHAEL R. OWENS
LENGTH: Medium: 72 lines
All humans face death, and most fear it, not just when morality is imminent, but throughout life. Our fear of death and dying has unfortunately guided our methods of treating the terminally ill in this country. In the past, we coped with a terminally ill loved one in one of two ways - we shied away from confronting it by shutting the sick and dying away in an institution, or we sought bizarre and expensive means of delaying or avoiding death. Recently, a new approach has surfaced that has received a large amount of media attention - assisted suicide, which Jack Kervorkian has brought to the public's attention.
We at the Sentara Hospice Program would like to offer a more humane and cost-effective approach that avoids the high cost associated with traditional methods of care and the high-tech associated with new and unproved procedures. The type of care we are speaking about seeks to manage pain, providing relief for those who are so desperate that they turn to Kervorkian's euthanasia method.
Hospice seeks to alleviate the fears most commonly associated with the prognosis of a terminal illness - the fear of pain related to the illness, the fear of becoming a burden to the family and the fear of financing the cost of a terminal illness.
The primary goal of hospice is to control pain. To do so, hospices rely on the combined knowledge and skills of a team of professionals - physicians, pharmacists, nurses, home-care aides, social workers, bereavement counselors and spiritual counselors - and volunteers who coordinate a personalized plan of care designed to help the patient live his or her final days as comfortable and pain-free as possible. The care often includes medication, equipment and supplies related to the terminal illness.
The fear of becoming a burden on the family is of great concern for many terminally ill people. Hospice addresses this concern. The hospice team of professionals works with the family, providing skilled nursing and psychological and spiritual care as well as everyday support such as shopping, cleaning and running errands. When needed, hospice provides respite care as well. In addition, hospice staff can be reached 24 hours a day and will visit, when needed, day or night.
Hospice is efficient and cost-effective; more than 90 percent of the care is provided in the comfort of the home. Care provided in the home has proved time and time again to be less costly than care in a hospital or other institutional settings. In 1994, the charges per hospital day were estimated at $1,756; care cost $284 in a skilled-nursing facility. That same year the Medicare base reimbursement rate for hospice routine home care was $91 per day.
Hospice services are covered under Medicare, most private-insurance groups and HMOs. Hospice is also a covered benefit under Medicaid in Virginia. In addition, through community contributions, memorial donations and other gifts, many hospices are able to provide services regardless of a patient's insurance or ability to pay.
As a result, hospice care is one of the fastest growing heath-care industries. Currently more than 2,000 hospice programs employ more than 33,500 full-time professionals and approximately 11,000 volunteers who together serve close to 280,000 terminally ill patients and their families each year. The need for hospice will continue to rise due to the growing elderly population, the increase in AIDS cases and the rise in health-care costs.
Hospice is a concept of care whose time has come. It is a program that treats the person, not the disease; focuses on the family, not the individual; and emphasizes the quality of life, not the duration. It is care that accepts death as a natural part of life and seeks neither to hasten nor postpone it. MEMO: Dr. Owens is medical director of Sentara Hospice Program.
by CNB