[Congressional Record Volume 151, Number 54 (Thursday, April 28, 2005)]
[Senate]
[Page S4539]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HOSPICE CARE

  Mr. NELSON of Florida. Mr. President, I ask unanimous consent that 
the following article be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

             [From the Tallahassee Democrat, Mar. 28, 2005]

           Hospice Offers Patients Expert, Compassionate Care

                          (By Jack D. Gordon)

       Watching the Terri Schiavo case unfold, we have gotten an 
     education that many would no doubt rather not get. Through 
     the news media, we've learned the mechanics of feeding tubes, 
     the importance of advance directives and living wills. We've 
     tried to understand the difference between a persistent 
     vegetative state and a coma.
       What we haven't really been educated about is the hospice 
     care of Mrs. Schiavo. Lurking dangerously close to the 
     surface of Schiavo controversy, quietly simmering, is the 
     false and dangerous illusion that hospice is a place that 
     hastens death, that it and those who do hospice work are in 
     some way accomplices.
       Sure, we have gotten a glimpse of Woodside Hospice in 
     Pinellas Park--we've watched the protestors outside, we've 
     seen photos of the family huddling inside, we've learned that 
     it's where Mrs. Schiavo's feeding tube was removed. But for 
     too many, Woodside Hospice is still one of those mysterious 
     places where people go to die.
       Yet hospice isn't ``a place'' at all. Hospice is a 
     philosophy of care focused on pain relief and symptom 
     management, and hospice is care given mostly in people's 
     homes. It can also be provided in a nursing home, assisted 
     living facility, a hospital, and--or, as in Mrs. Schiavo's 
     case--in an inpatient hospice facility.
       No one is ever forced to use hospice care. People either 
     choose hospice care themselves or their health care 
     surrogate, designated as responsible for their best interest, 
     makes the decision. A physician outside of hospice is also 
     involved. He or she must certify that the patient's illness 
     is terminal and that life expectancy is six months or less.
       Hospice clinicians are experts at providing comfort in the 
     final months, weeks, days, hours and minutes. In many cases, 
     there is time and opportunity to address family, spiritual 
     and psychological concerns with hospice professionals, who 
     work in teams that include physicians, nurses, social 
     workers, physical therapists, and clergy.
       It is not usual for those under hospice care to outlive 
     their life expectancy of six months or less. In a study 
     conducted by the University of South Florida, it was found 
     that persons with cancer who received hospice care lived an 
     average of one day longer than the same patient, by age, 
     gender and diagnosis, who were cared for in acute care 
     facilities such as hospitals.
       Our ignorance of hospice isn't so surprising. On our 
     nation's health care timeline, it's a relative newcomer, but 
     it has been gaining in use each year. The first U.S. hospice, 
     an inpatient facility, opened in 1974. In 1978 there were 
     about 1,000 people in the United States who died under 
     hospice care. In 1983, it officially entered the mainstream 
     when it became a Medicare benefit. By 2003, 885,000 people 
     died under hospice care. This year, close to a million people 
     in the United States--or one-third of all who die--will die 
     under hospice care.
       Despite its monumental growth, there has been no widespread 
     government outreach effort around publicizing the benefits of 
     hospice care. Hospice physicians and nurses, in the midst of 
     new technologies, therapies, drugs and procedures, march on, 
     quietly accepting what no one to date has successfully 
     escaped--death. They do this by helping the terminally ill 
     die dignified deaths free from artificial life support or 
     ineffective treatments. They employ the latest methods to 
     relieve pain and control symptoms, but their mission is not 
     to cure. Admittedly, in our culture that rejects illness and 
     aging, that's tough medicine for many to swallow.
       No matter what your opinion of the Schiavo case, be happy 
     that Mrs. Schiavo is being cared for by people who have 
     helped thousands of people experience a gentle and caring 
     end. And know that the hospice in your community will not be 
     making the decision of whether you will live or die, but if 
     you should become seriously and terminally ill and choose 
     hospice, know that the nation's more than 40,000 hospice 
     workers are committed to the highest quality comfort care 
     under medical guidelines.

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