CASTRO, ARLYN F N302

Hospice care for the dying alive and well in RP.

Asia Africa Intelligence Wire | November 01, 2010 | Copyright

so big it weighs about 10 kilos, said hospice nurse Vangie Labitoria. When the Inquirer visited her recently, Solis was walking down the street with that weight on her left breast, but she was all smiles and with nary a look of self-pity. She had just finished doing the laundry, she said, and she had a full clothesline to show for it. Solis has been enrolled in Madre de Amor for three years now. She looks forward to the weekly visits and she receives her regular supply of morphine to ease her pain. For her, surgery is no longer an option. She shunned surgery after she was diagnosed, she said. She was amazed she had lasted this long, outlasting four women who had undergone surgery. Maggots were eating away the breast of Enriqueta Moslares when nurse Vangie first visited and examined the newly enrolled patient. The nurse immediately cleaned the open and putrid sores. This she did every day without fail in order to be ahead of the maggots. After two months and a half under hospice care, Moslares, 71, died of cancer complications. A Catholic, she was given the last rites and the sacraments. During one of the nurse's visits, Moslares told her: "I know that even if I live very long, you will continue to visit me and take care of me." Death of a teener When Sarah Katrina Adriano died of nasopharyngeal cancer in August 1993, there was little that could ease the pain of her parents, Fermin and Lourdes, both professors of the University of the Philippines Los Ba[currency]os in Laguna.

(From Philippine Daily Inquirer) Byline: Ma. Ceres P. Doyo "DEATH is the natural end of life. It is not the failure of medicine." These were the words of the late Dr. Josefina B. Magno, hospice pioneer in the United States and the Philippines. Hospice care for the terminally ill and dying is alive and well, thanks to Magno's groundbreaking efforts and the quiet dedication of individuals who seek out those who are in need of palliative care and comfort. Thanks, too, to a young teenager named Sarah Katrina Adriano, who passed away in 1993 at the age of 14, and her parents, who had sought ways to make sense of their loss and pain. In the process, they discovered warm places in the hearts of generous persons and all together they created a path to a different kind of healing. For 10 years now, the Madre de Amor Hospice Foundation's volunteers and medical workers have been scouring areas around Laguna Lake, visiting homes and hovels, places where there are persons waiting out their final days. Painphysical, emotional and spiritual-need not be their constant bedside companion. Most people think of hospices as institutions with in-patient facilities. Madre de Amor's hospice service is "home-based, for free and rendered at the grass-roots level." Anicia Solis, 47, married with four kids, has a cancerous breast tumor that she has been carrying around for five years. The tumor is now

A beautiful and gifted teener, Sarah was every parent's joy. Shortly after her death, her parents attended a seminar on hospice care under Magno. They wanted to do something for those who were suffering like their daughter did. Among those who attended were Dr. Rhodora del RosarioOcampo and Evangeline Lopez-Labitoria, both now working full time with Madre de Amor. Magno, an oncologist, was the pioneer in hospice care in Washington DC and Maryland. In the 1970s, she started the hospice unit of the Henry Ford Health Care System in Detroit, Michigan. She founded the International Hospice Institute for the training of medical professionals in hospice care. In 1993, she received a mandate from the World Health Organization to introduce hospice care to developing countries. She decided to start in the Philippines. Madre de Amor Hospice was launched on Aug. 21, 1994 in Los Ba[currency]os. It was named in honor of the Blessed Virgin Mary. The first hospice volunteers underwent training for nine consecutive weekly three-hour sessions. A few months later, Madre de Amor coalesced with a Manila group led by Carolina G. Guerrero (present chair) and together, they formed a foundation. Madre de Amor's free services now extend to seven towns. Like sponges After attending their first international symposium on cancer consciousness and learning from palliative care experts, 11 volunteers, a nurse and a doctor began their first clinic. "We were like sponges, absorbing all the knowledge we could find about the hospice and

modifying the techniques abroad to suit our community setting. And when we were able to go abroad and meet Dame Cicely Saunders, the founder of modern day hospice, she affirmed what we were doing and inspired us to go on," recalled Ocampo, a hospice medical director. Ocampo, who is not quite middle age, has been with Madre de Amor since the beginning. "It has taught me more than I could ever give to it. It has taught me to be humane and compassionate. It has taught me to be resourceful and resolute, how to focus and to always keep my eye on the finish line. I cannot imagine my life without the hospice." The late advertising executive Antonio Mercado, the foundation's first president, gave Madre de Amor a permanent home. [9957 Amethyst St., Los Banos Subdivision, College, Laguna. Tel. (049)5360644.] Mercado valued spiritual support for the dying through prayer and the sacraments. He initiated the prayer-partner support system with the dying patients. After Mercado died in 2000, his wife, Monina Allarey-Mercado, became the president. She has just finished editing "Hospice Stories," a book on Madre de Amor's 10-year journey with the terminally ill. It contains more than a hundred mini-stories about the dying and those who cared for them. Wind beneath the wings Magno, the hospice volunteers said, was "the wind beneath our wings." She explained hospice care thus: "This is the moment when the physician can say to the patient: 'I can no longer cure you, but I can continue to care for you.' In these words lie the definition of hospice care and the physician's

role in it. The words, 'nothing more can be done' applies only when we are thinking of a cure. There is no limit, however, to what the physician can do to palliate and to comfort." Magno, Madre de Amor's first chair, died in 2003 at the age of 83. Hospice president Allarey-Mercado said that, in a sense, their work was a pioneering one-the care for the incurable and the dying in the Philippine context. "In hospice," she explained, "the principal focus is the control of pain and not the cure of the disease. Palliative, not curative. In the Philippines, this idea is new." All the elements of hospice-spiritual, psychological, social and emotional support-are as old and basic as human compassion itself, she said. Morphine and love Madre de Amor's volunteers (about 30 now) and medical staff believe that pain-killers, given under careful medical supervision, can relieve the patient of unbearable pain. This enables the patient to live as normally as possible until the end. Said Allarey-Mercado: "He is able to remember and to remind, appreciate, say goodbye and 'I love you.' He is able to pray." Madre de Amor gets its morphine supply from the Department of Health. Most patients take it orally, others use morphine patches. They and their families are given an orientation on how and when to use it. Morphine is not readily available to anyone or just to any doctor. But it is not just the physical pain that has to be dealt with. Many patients are in need of love, reconciliation, forgiveness and most of all, peace.

Since 1994, Madre de Amor volunteers and staff have assisted more than 400 patients and prepared them to cross the threshold. Their patients die in their arms. They know their names-old and young, men and women, the majority poor. The youngest was four, the oldest was 93. Learning from the dying Nurse Vangie sheds tears for each one of her patients every time. She's had her bouts with near emotional burnout, but she has learned to deal with them. "I go to the pastor of my church and tell her how I feel." Volunteer Teresita Gonzales was herself a survivor of cancer. Her healing was miraculous, she said. "There is a lot we could learn from the dying," the former teacher said. "We realize we are finite, death is inevitable and we have to make each day count." As Allarey-Mercado wrote: "Dying persons are the best teacher of priorities. For the volunteers, the patient and his family, there opens a whole new avenue of courage, compassion and bonding. "Hospice means healing-the healing of fears, resentments, loss of control, helplessness, loneliness and the vast uncertainty of hovering at the brink of death. "Hospice means that when cure is no longer possible, healing can begin." Reference: http://www.accessmylibrary.com/coms2/summar y_0286-14208808_ITM