The Washington area's first hospice, a six-bed facility for the care of dying cancer patients, was dedicated yesterday at a Northwest Washington nursing home.
The hospice is to be the site of a two-year study of the possibility of paying for such care through privately managed insurance coverage. The facility is in the Washington Home, formerly the Washington Home for Incurables, an 89-year-old private nonprofit nursing home at 3720 Upton St. NW.
According to Dr. Arthur C. Upton, director of the National Cancer Institute and keynote speaker at the dedication, the Washington hospice is "the first anywhere to function in an established nursing home."
Hospices are designed to provide care, rather than cures, for terminally ill patients. The chief goal of a hospice is to provide relief from pain and other symptoms of illness in order to allow patients to live as normally as possible until death, rather than spend their last days conscious only of the fact of dying. The hospice at the Washington Home will provide care exclusively for cancer patients.
There are more than 30 hospices in Great Britain, where the modern hospic concept originated, but only a handful of such facilities exist in this country.
The hospice "reflects the finest humanistic values and traditions of the medical arts," Upton said. He said there is a great need for hospices because there are "few facilities now available for the cancer patient and his family" after all conventional treatment has been exhausted.
Most hospices are bright, cheerful places where patients, their families and the hospice staff can share the patients' remaining days. However, the four rooms that constitute the hospice at the Washington Home are high-ceilinged, barren and institutional-looking, despite fresh coats of brightly colored paint. The rooms - two singles and two doubles - are in a 54-year-old building.
Patients will have to walk down a short flight of stairs to join their families in a modern and comfortable visiting room, and the room offers little privacy for family gatherings.
However, Dr. Josephina Magno, a cancer specialist at Georgetown University and leader in establishing the Washington Home's hospice, said the hospice has been designed more as a vehicle to study the problems involved in insurance coverage for such care than to prove anything about the hospice concept.
The hospice is a cooperative venture between Georgetown's Vincent T. Lombardi Cancer Research Center, Blue Cross and the home.
"When we first started the project the real objective was to define the role of third-party (insurance) carriers," said Magno, acknowledging the physical drawbacks of the setting in the home.
"The Washington Home presented itself because there are 24,000 nursing homes in the United States today, and if we really want to impact the care of the dying, the data that comes out of the Washington Home can be replicated in any nursing home in the United States," she said.
"It's important to see how the hospice concept will impact the nursing home," said Magno. "Will the hospice concept affect the type of care in the (entire) nursing home, or will the nursing home gobble up the hospice?"
Care in the hospice will be available only for those who are not suitable for a home care program, are suffering from terminal untreatable cancer and have Blue Cross coverage. A bed in the hospice will cost $135 a day, Magno said, compared to a minimun of $235 a day at Georgetown University Hospital.