HospiceCare, Inc. welcomes Russian Visitors
The Fitchburg Star (Fitchburg, WI)
Posted on August 29, 2002
By Jessica Jones
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| HospiceCare, Inc. recently welcomed medical professionals from Russia as part of a cultural exchange program. The across-the-globe visitors learned about how hospice care works in the United States as well as some issues that Dane County's only hospice center grapples with. |
The group, hosted by the Friendship Force of Wisconsin, came to Wisconsin as part of the Open World Program established by the US Congress. Since 1999, several groups made up of young Russian leaders have visited the United States to learn about all levels of the U.S. government, as well as nonprofit and/or private institutions, such as HospiceCare.
Donna Calver, director of the program for this most recent Open World group to visit Wisconsin, describes the Open World program as a new approach to introducing people from other countries to American politics and culture, and a way to create better relations between the United States and Russia. The visit to HospiceCare was a successful example of these goals, combining a friendly atmosphere with education.
"We definitely enjoyed the time at HospiceCare, " Calver said.
The Open World group began their visit at HospiceCare with a short introduction to the facility given by HospiceCare's Community Relation Director, Todd McVey, assisted by a Russian interpreter. The group learned the details if HospiceCare, including its mission, the types of treatment and services the facility provides, and the volunteer program.
The introduction included a question and answer session, in which the Open World group asked questions about HospiceCare, Inc. specifically and general hospice care in the United States. The group was very interested in how HospiceCare worked, and asked about the capacity of the building, the number of staff members and about the grief counseling services HospiceCare provides.
Some questions sparked conversation and debates in Russian between the group members.
When Russian visitors asked about the use of euthanasia, and McVey informed the group that euthanasia was not only illegal but also against HospiceCare's philosophy, the group began a steady steam of discussion in Russian that lasted for several minutes.
The HospiceCare staff also learned a little about Russian hospice care in exchange. Dr. Tatyana Parsenova, a member of the visiting group and a medical psychologist at a Russian hospice, explained that the majority of the patients her hospice serves are treated at home, like HospiceCare's patients are, and that her hospice also has a much smaller volunteer program.
After the introductory meeting and question and answer session, McVey led the group on a tour of the large facility, detailing each room's purpose and highlighting the unique aspects that make the facility feel more like home and less like a hospital, such as the framed art on the walls in the impatient room that hide medical equipment in the behind them.
The group also met with Dr. Bill Rock, one of the three medical directors at UW- Madison and the retired medical director of Dean.
The Russian visitors spoke with Rock extensively about pain medications in the United States and discussed Rock's Support for the use of pain medication outside of hospice care, a view with which many of the Russian doctors seemed agree.
Dr. Rock also discussed malpractice suits with the group in response to a question on the subject from a Russian lawyer who handles malpractice in Russia.
The group talked at length about the intricacies of malpractice suits and insurance, and was pleased with Dr. Rock's charisma and willingness to discuss many subjects.
Among the many issues the group explored and discussed were two of the major issue that a hospice faces in the United States, and specifically in Wisconsin.
Wisconsin hospices presently deal with two main issues: the lack of Medicaid coverage of the room and board expenses for patients, and the need to legalize a hospice nurse's right to pronounce the time of death of a hospice patient.
HospiceCare serves patients in the patient's home, a separate facility or in the HospiceCare building itself. Medicaid currently covers the medical needs of residential patients, but does not cover room and board. The problem is, as staff explained to their Russian visitors, rooming costs can add up, even over the short period of time patients stay as residents at the hospice.
HospiceCare, which has a policy of never turning a patience away, raises $15 million in community support dollars a year, and with these funds the facility is able to cover the difference if a patience medical needs are not completely covered under his or her insurance. The hospice is financially unable to cover the $190- per- day cost of room and board for residential patience who cannot afford it. In such cases, HospiceCare staff help patients find another facility in which to stay.
HospiceCare has sent out letters to all of the representatives in the facility's service area seeking support for complete Medicaid coverage for room and board expenses, as well as other issues. So far, only Rep. Rick Skindrud (R-79th District) responded to HospiceCare's communications and visited the facility in July.
HospiceCare and other hospices around the state seek to benefit patients and their families in another way as well. Currently, by Wisconsin state law, hospice nurses cannot pronounce the time of death of hospice patients. When a patient dies, the hospice nurse must contact the physician or call and report that the patient has no heartbeat or respiratory effort. The physician will then pronounce the time of death for that patient. Many times this procedure is done over the phone.
A number of difficulties come with this system, says Jane Quinn, inpatient director at HospiceCare. If a patient dies late on a certain day, the hospice nurse may not be able to reach the physician before midnight. If the physician calls back after midnight to pronounce time of death, the patient's date of death will be different on his or her death certificate than when he or she actually died.
Quinn says that the phone call and the obstacles that hospice nurses and families of patients experience during the death of a loved one "is just an unnecessary delay in time. There's so many emotional things going on, one more phone call is too much," she said.
© 2002, The Fitchburg Star. Used with permission.
[Reprinted with Permission]
