"Like many people, I've seen a close relative die an unpleasant death in inappropriate surroundings," said Edward Kelly, chairman of the board of the Health Systems Agency of Northern Virginia. "I think that's why there's so much enthusiasm for hospices."
Kelly was one of nearly 20 speakers who testified this week before a Virginia House of Delegates subcommittee in favor of hospices. Hospices are facilities geared to aid terminally ill persons - most of whom have cancer - and their families.
The hearing, the last of two statewide hearings, was held in Falls Church.
A new concept in medicine, hospice care emphasizes that patients be allowed to die with dignity, with as little pain and as much control as possible. The goal of hospice care is to allow patients to die at home, but when that is impossible, patients enter inpatient hospices where the regime is [WORD ILLEGIBLE] to each patient. Critics of the controversialy concept, introduced in Britain a decade ago, say that dying patients can best be cared for in hospitals or nursing homes.
"We're really interested in what the state needs to do to make hospices possible," subcommittee chairman Mary Marshall (D-Arlington) told those attending the hearing, including cancer victims, local officials, physicians and hospital administrators. According to Marshall, the subcommittee will recommend new legislation in January.
Hospice of Northern Virginia began a home-care program last March and hopes to open the state's first inpatient facility next year. The 20-bed hospice would be in Arlington's Woodlawn High School, which closed last month. Inpatient hospices currently do not meet state licensing requirements because the state does not recognize the existence of hospices. Only hospitals and nursing homes are recognized.
"A hospice is not a nursing home or a hospital," Kelly told the subcommittee. "There must be amendments (in state law) to provide for specific regulations for hospices."
"Today we find it very difficult to die at home," said the Rev. Sidney L. McGuire of Fairfax County, noting that 20 percent of Americans die at home. "All kinds of technical intervention stand between the patient and the family, the patient and the doctor.
"Most institutions look askance at people who break their rules. The administrator (of a hospital or nursing home) is not happy when an old lady brings her cat or canary in and wants to die with it. We need a facility apart from the rules and regulations of insitutions."
Like several other speakers, McGuire urged the subcommittee to recommend stringent licensing requirements for hospices in order to limit the number. "There is a strong incentive for people to make a fast buck," he said.
Del. Richard L. Saslaw (D-Fairfax) asked Richard Pastore, chairman of the board of Hospice of Northern Virginia, for cost estimates of hospices care. Pastore said he estimated the cost at $80 per day, half the cost of hospital care because of the lack of expensive machinery.
"One of the vital parts of this whole program is that once people have been diagnosed terminal is that they have not only a right to die in dignity but without paying $200 per day to do it," Saslaw said.
The most dramatic testimony came from cancer patient Garde Chessnoe of Annandale, whose cancer was discovered 11 years ago when she was 44."Who is going to help me die?" said Chessnoe, who spoke extemporaneously and earned the rapt attention of the subcommittee. "You all like to think you will be quite old and will die in peace in your sleep and that it will be beautiful. Cancer is not beautiful, it's a very nasty business."