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Hawaii’s World
YOU won't see an ad like this, but I rather wish you would: More people should
use hospices
I am no longer involved with either St. Francis Hospice or Hospice Hawaii, the two providers on Oahu.
WHAT'S SURER THAN TAXES?
DYING, that's what!
Why not do it comfortably
and with grace?
Call Hospice months before the event.
You and your loved ones will never regret it.
But I know they still are lovingly managed and can do wonders in the grace and comfort area for both terminally ill people and their loved ones.
I know, too, that they have a common complaint. Patients ask their help too late -- only about 20 days before dying on the average, sometimes only a few days before.
The U.S. government, which is fairly hard-headed about such things, is willing to fund hospice care for the last six months of life under both Medicare and Medicaid. Many medical plans do, too.
For most terminally ill people, hospice is a win-win choice. More appropriate care. Lower cost.
My first encounter with hospice was in London in 1977. The Star-Bulletin had run a series of articles on the inadequacies of terminal care. I wanted to see it done right.
I arranged to visit the very first modern hospice, St. Christopher's, in a quiet, middle-class residential district of London. It was a homey building where the nearly daily arrival of ambulances and hearses was mostly out of common view.
I entered with some apprehension, went away uplifted. One particular unplanned incident is illustrative. A woman rushed up to my doctor-guide to exclaim: "Oh, Dr. West, my father has his sense of humor back!"
Her father was a comic on the British stage. He had been miserable at home in his final illness. St. Joseph's got rid of his pain, kept him in caring surroundings, and soon he was wise-cracking again.
Today hospice care can be either in-patient or at-home. The difference that makes either succeed is the loving skill of hospice personnel in ending pain, counseling loved ones, and arranging for an orderly closing of personal affairs .
The big hurdle -- the one that makes most admissions too late -- is that the patient himself or herself must recognize his or her terminal status, then ask to shift to hospice care.
This can be a terrible wrench, but one for the better. Many physicians are reluctant to push it. Perhaps they see it as a defeat for their aggressive treatment efforts. Timed right, it is a wonderful relief from them -- and that means timed several months before death rather than just 20 days or so.
I'm sorry you aren't likely to see the above great public service ad anywhere but in this column. But do keep it in mind.
When you or someone close to you is in need, don't hesitate to call a hospice, if only for advice:
Both have been at their kindly work for some 20 years and draw overwhelming praise for their efforts.St. Francis Hospice's Sister Maureen Keleher Center at 595-7566
St. Francis has in-patient facilities in Nuuanu Valley and at its hospital's West Oahu annex. Hospice Hawaii has one at Enchanted Lake. It recently authorized a search for a Honolulu location.
Some readers know me as an advocate of doctor-assisted death in certain unbearable circumstances. But these likely would be less than 100 a year statewide. Hospices in Hawaii help about 1,500 people a year. They could, if asked, help several times that number.
A.A. Smyser is the contributing editor
and former editor of the the Star-Bulletin
His column runs Tuesday and Thursday.