the "baby boom" generation draws closer to retirement
age, our nation faces an explosion in health-care costs. We will
need to explore innovative strategies to hold costs down, while
at the same time maintaining the highest quality of care to people
with incurable illnesses, and while at the same time holding down
the costs that come with the extensive medical care of a terminal
illness. Connecticut's hospice program is an excellent model for
the country as a whole to follow.
Connecticut led the way for the nation when America's first hospice
care unit opened in the early 1970s. In 1978, the Connecticut Hospice
created the research and teaching component for hospice care with
the opening of the Hospice Institute for Education,
Training, and Research. The Institute fostered ground-breaking research
in issues surrounding care for the terminally ill.
Thompson Institute and the Connecticut Hospice program have thrived
and expanded since that time. Based on the success of these models,
hospice units have moved from Connecticut to hospitals and nursing
homes throughout the nation. Countless numbers of terminally ill
patients across the nation depend on the care they receive through
hospice. In this, along with so many other health-care issues, Connecticut
has provided an example to the nation in promoting a health-care
climate in which the needs of the patients and their families come
is a blessing for the patients and families who depend on these
services. As a cancer survivor and a strong hospice supporter, I
understand how hospice can
Congresswoman ROSA L. DeLAURO, Connecticut's
Third District, was first elected to Congress in 1990 and was reelected
in 1992, 1994, and 1996. At the beginning of the 105th Congress,
was renamed to the Appropriations Committee, where she had served
during the 103rd Congress. She sits on the Labor/ HHS and the Agriculture
Subcommittees. During the 104th Congress she served on the National
truly become a second family for patients grappling with a serious
and terminal illnesswith a talented and caring staff who are
always ready to help when they are needed, and patients who spend
time together, reaching out to offer loving support. A hospice inpatient
unit is more than just a hospital wardit is a true community.
a pioneer in the hospice movement, and is again blazing a trail
in the area of heath care with the Physician Assisted Living (PAL)
Partners initiative, announced in September by Attorney General
Richard Blumenthal. This program is geared to inform people about
hospice care and to give them the opportunity to consider their
options at a time when they are healthy and not immediately facing
a terminal illness.
a diagnosis has been made, it often becomes difficult to make an
educated and informed decision as to medical treatment. Conflicting
emotions rage out of controlanger, fear, denial, deep depression
are all too common, not just for the patients, but for their families
as well. When patients are trying to come to grips with their own
mortality, it is difficult to focus and make educated decisions
on issues as to what medical treatment they want and what measures
should be taken (or avoided) to prolong life.
care can help ease the pain and suffering that comes with a terminal
illness. Hospice allows patients to spend their final days in a
caring atmosphere where pain is controlled and where sufferingboth
physical and emotionalcan be minimized.
with doctors, religious organizations, hospice, and other medical
groups, PAL will help to educate Connecticut citizens regarding
the range of their options before they come face-to-face with that
most devastating of news.
initiative is aimed at increasing doctor-patient collaboration.
Doctors are educated as to available hospice programs and encouraged
to sit down with patients to discuss the possibility.
The program includes a directive to be signed by the patient indicating
her desire to receive hospice care should she ever be faced with
a terminal illness. Although this document is not legally binding,
it affords an excellent opportunity for patients to play a role
in their medical care.
choice in health care is an issue at the top of our nation's agenda.
Choice of doctor, specialist, treatment, and even length of hospital
stay is increasingly being made by insurance companies rather than
by the doctors and patients who should be making these important
that is exactly what PAL is designed to foster conversations
and decisions made between doctors, patients, and family. The 10
principles incorporated in the program are common sense and flexible,
and acknowledge the fact that every case is different. But the key
standards remain the same, among them: addressing the needs of the
patient and his family; allowing the physician to coordinate medical
services; controlling symptoms through physical, sociological, spiritual,
and psychological care; and coordinating home care and inpatient
faced with a serious illness, understanding the implications and
making decisions regarding the course of
medical treatment is often one of the few things patients can
do to maintain a measure of control in their lives. Critical illnesses
too often take decisions from you; the idea that you are no longer
in control of your body is difficult to fathom; it can be unimaginably
more frustrating when an insurance company takes away that control
care, and the PAL program, helps to put that power of control and
decision making back in the hands of patients and their doctors.
Patients can stand up and say what type of care they want and what
care they do not want. Hospice home care allows patients to retain
their independence and spend time with their families while receiving
care to control pain and monitor their illness .
home care also helps to control costs; home care is far more cost-effective
than treating a patient in a hospital for along period of time.
As we move into the next century and attempt to find strategies
to prolong the life of the Medicare Trust Fund, home care is an
option we must explore in greater detail.
proud that Connecticut has again put itself out in front in the
evolution of our heath-care system. From the start of the hospice
movement, to ensuring that all patients have knowledge of and access
to the options available, Connecticut has led the way. As we see
the PAL initiative move into action, I hope that Connecticut will
once again prove itself to be a model for the nation.