In America and other neighboring countries, The hospice concept of care has been part of their healthcare continuum for 20 years. At the foundation of hospice care are interdisciplinary teams of skilled professionals and trained volunteers  that provide physical, emotional and spiritual comfort to persons with life-limiting illness. Whenever possible, hospice care is provided at home, but it can also be available in inpatient settings or long-term care facilities. Key to the hospice philosophy is the support of the patient's family in giving care and in the grieving that continues after death. The values and choices of the patient and family  are respected.

But the depth and breadth of hospice expertise are often underutilized. Human resource managers  and employee assistance professionals can turn to their local hospice programs for help in a number  of   areas.

Hospices offer experienced counsel to families making end-of-life decisions. When facing serious, progressive illness in the family, employees may struggle for answers to wrenching questions. What choices in care and treatment are available? How do we know when treatments are a burden    rather than a benefit? Hospices help families face these questions every day. In the absence of living wills or other advance directives, family members are often asked to make decisions about treatment or resuscitation; hospice professionals offer information and guidance to make decisions that are  consistent with each family's values.  

Unknowingly, due to lack of materials and information drive regarding Hospice Care, Now I realized I did practice this for 16 years already. I remember when I took care of a very loved grandma in the person of Mommy Garcia , Dr. Thelma G. Abiva’s mom.  She was so sweet and very kind. Her last words, “I do hope my family can still have you as their nurse.”

Who  questions my experience with Paola Ojeda Luz ? I remember my devotion to the blessed Virgin since I was in Grade IV, but when I started taking care of her, I learned to pray the 15 mystery rosary every day. She taught me to really understand the ordeal of a dying person. She was so serious when she called me on the phone , she will be dead at 2 pm, but she made me promise to continue and share my way of services to others. “I do hope, she said , maaalagaan mo muna lahat ny dying patients bago sila sumakay sa last trip” Magpadami ka kasi!

The media often portrays dying as a lonely time of pain and suffering. Family members can be comforted in knowing that hospice is an alternative that offers comfort and dignity until life's end. "Dying does not have to be agonizing," says noted palliative care physician Ira Byock, M.D. Writing in the newly released Dying Well: The Prospect of Growth at Life's End, Byock says: "A person's dying may not be easy, but what of value in life is? Similarly, caring for our loved ones as they die is simply part of full and healthful living."

While Medicare, our new National Health Insurance , and virtually all managed care or fee-for-service plans here in the Philippines have no hospice benefits, and many  Filipinos have inadequate insurance, or may not be insured at all I am telling everyone that Hospices provide affordable access to quality care and offer significant value to both patients, family and my fellow filipino people. The expense of healthcare at the end of life can potentially impoverish many families, but hospice care can greatly reduce that financial burden. Everyone  will be relieved to know one of the tenets of hospice care : and of course I promise that in my center all appropriate patients are served, regardless of  ability to pay.

In America, for those who seek care for Medicare beneficiaries when life expectancy is six months or less, the  Medicare Hospice Benefit is good news. Medicare offers a hospice election that is separate from its other reimbursement structures. All services, medications, treatments, respite care, supplies and  equipment which are part of a hospice plan of care are fully covered, with a minimal co-payment for prescription drugs and respite. Patients and their families who elect hospice care do not even need to  file claims. Most states have a similar hospice election for Medicaid recipients, and CHAMPUS  benefits are structured in the same way.

I am sure this will also be possible here in the Philippines.I started adopting loved dying patients already without conditions so my countrymen will be convinced and understand the principle , then  encourage those who has the leadership skills to start preparing the program to be presented to our political leaders. I am very much willing to assist when datas are needed. Instead of  leading a group blaming the government about  unnecessary things, you better start a cause  which will definitely be serving  the next generation. Isn’t it nice to be a part of history? We may not be able to enjoy it now but it will benefit our children and our children’s children.

In America, when benefits managers insist on health plans that include a well-defined hospice benefit, significant cost-savings are realized. According to the 1994 American Statistical Supplement to the Social Security Bulletin, charges for one hospital day averaged $1,756, and one day in a skilled nursing facility   averaged $384. The routine home care charge for one day of hospice was $191. In my center , the original rate I expected to ask is the prevailing rate of a private duty nurse equivalent to $ 100 x 24 hours, offering families free charges from other needs even when admitting patients in my facility. Hospice rates have risen at a fraction of the increase in fees for other care since that time. A 1994 Lewin-VHI study estimated that for every dollar spent on hospice care, $1.52 was saved in more expensive care.
     
I prepared this program for Hospice training with a manual which will be very easy for everyone to  follow  and comprehend. Started wrapping in 1985 through researches and self case study with my actual patients and their families, relatives and friends as the leading roleplayers. Some of my patients are already there but I still have their families left whom I really involved in their care and preparation for their journey. I promised “THEM” eternal joy but given them assignments upon arrival. I made them promised me to tell my Almighty about this blueprint I am preparing so as to double my harvest and really be able to help more families. To make my project studyrealistic and easy to achieve, I prepared one program with different presentations at different phase for different levels of understanding. I can share my program with a group of intellectuals and hard to please filipinos. The professionals and the medically oriented fellows can also benefit from it. Out-of-school youths, the confused and those who can not read groups can also enjoy. I even prepared a program for five year old, playful kids which I believe is realistic because I started it with my Carmela .

Hospices offer practical help in managing day-to-day living and compassionate alternatives  when home care is not possible. Where can my loved one be cared for?  What help is available in my community?  Who can  teach me what I need to know? According to a 1996 USA Gallup poll, nearly 90 percent of surveyed  adults believe that it is the family's responsibility to care for the dying. With the help of hospice professionals and volunteers, employed family members often manage to continue their work while caring for their loved one at home, thanks to the resource management for which hospices are  known.

It is the family's responsibility to care for the sick and the dying. Filipinos, I believe are born natural caregivers. With our traits, being sentimental , with our cultures and practices, sending a loved one to a facility is a big NO! NO! to the vast majority. But  Philippines today is very different from Philippines yesterday. Families before used to live in very big houses. Women before are just plain housewives to take care of the family members daily needs like food and laundry so with taking care of the kids and the sick. We are also practicing the extended family way of living. We were made to believe that a parent who can house all their children even after marriage and have kids of their own in one house is ideal, so as not to cut the bonding and closeness … I still can remember when an aunt spinster of mine kept telling me if I will be the one to take care of her when she gets old , I was so young then …3 or 4 years old ? Of course, can you imagine guilt feelings that will be developed even the thoughts of sending her to a nursing home. Everybody in our family loved her very much … She died due to uterine carcinoma in 1991.
Filipinos then learned to adjust to practical way of living. Wives are now working,  Big houses are now reconstructed to be condominiums to earn and just live in an area comfortable enough for everyone to rest and sleep especially at night.

Yes, I do encourage home care, With the help of my trained hospice professionals  caregivers and bedside nursing assistants and volunteers, employed family members can now manage to continue their work while  my group can continue caring for their loved one at home, but what if ?

ASIAN Institute of Health Care Hospice offer practical help in managing day-to-day living and compassionate alternatives  when home care is not possible. Ask yourself, Where can my loved one be cared for?  Where can I get real care when I get old ? Is it possible for me to go to that place now so I can observe and give suggestions to be sure of  the care I will receive?  Is there a possibility of being relaxed and at peace when I am now used to visit the place while I am still strong? 

Wow, that was really self preparation and of course self  acceptance that Death is a part of life, Everyone must be prepared for, IT comes like a thief in the night. What help is available in my community? Who can  teach me what I need to know? Can you imagine a 2 bedroom place with your kids and your dying love one there? What comfort can you give them? With lots of work and issues to ponder from the office, can you still give quality interaction with your dying love one during this last moment with you? It might be very stressful for both of you and your spouse and your kids

It was really my  calling to open a centre where all my dreams and obsessions  in the way caring for the sick, bedridden and especially the dying are  delivered without being  shortened.  My exposure to all 5 star hospitals made me opened my eyes how majority of the present Bachelor of Science in Nursing Registered Nurses  answered to their patient’s  and patient’s relatives calls and requests.

When I  started piling the foundation of my visioned calling, I met lots of trials. This idea was already active and keep coming back alive like a movie,  in my mind since 1972 when my maternal grandfather was diagnosed of Bronchogenic Carcinoma. I prepared myself, equipped with all the needed knowledge and practiced all learned skills with rationales that are for future use. Trials that came like typhoons and volcano eruption made me more strong and determined , to promise every filipino a reassurance that their future as possible hospice guests,  if they be given the chance to prepare their long journey HOME will really be the start of their paradise or heavenly  living.
 
Unlike standard home health care which decreases services offered at the time of program  admission, hospice services become more intensive over time. Hospice nurses, physicians and aides teach the necessary skills for care while social workers, psychologists, priests and chaplains provide emotional and spiritual  support.Twenty-four hour on-call availability and a network of extraordinary volunteers provide a  safety net. Access Professional Nursing Care Center offer volunteers to run errands, give family caregivers a break, and provide an extra set of hands or a listening ear.

When home care is not an option, my centre will continue training others to open their own facility too. The more interested individuals like me will be given the chance to serve. Patients then will receive the same full spectrum of hospice home care services like my facility. My center will be their homebase/headquarter to establish a uniform inpatient care for residential or acute care, further expanding caregiving options. New programs, such as day hospice care, will continue to evolve as Access Professional Nursing Care Center strive to meet changing needs.