April 2, 2012
Dear Mr. Duncan,
I am writing this letter in support of the laudable effort by the House of Comfort Foundation to create a new hospice home within Aroostook County, Maine.
As a cancer doctor who has been practicing in the community for over two years I have often been amazed at the high incidence of cancer in this community. Maine is one of a handful of states within the US with a very high cancer incidence and in Maine, Aroostook county ranks highest in cancer incidence. This translates into a high need for cancer related services including “end of life” care.
At the time of writing this letter, hospice services in Aroostook County are offered as an outpatient visiting nurse service under the guidance of either the patient’s medical doctor or the hospice director. While no words can describe the remarkable work done by this visiting nurse, there is clearly a need for improvement in the “end of life care” infrastructure available to our patients. There is no inpatient hospice available in the county and the pressing need for this will be highlighted by a few real examples mentioned below.
One of my patients was a young lady in her mid thirties who was dying from advanced cancer; she had accepted her prognosis and wanted comfort care only. She had three young children. She wanted to be among her loved ones during her last days but did not want her kids to see her actively dying at home as this would be a very traumatic experience for them. Unfortunately, due to a lack of a hospice home, this patient was eventually admitted to a hospital in the last days of her life.
Another young patient had leukemia and had tried a lot of therapies before eventually accepting her prognosis and choosing home hospice. However, her family members were unable to accept this and despite being on hospice she was brought to the hospital on numerous occasions with expected complications of her leukemia. Had she been in an environment where trained end of life caregivers were attending to her, repeated unnecessary hospitalizations that cause undue burden to the patient, their family and the medical facilities could have been avoided.
While the above two situations highlight the utility of hospice home care, they are not the most common scenarios. The most common example is that of an octogenarian patient who is suffering from advanced cancer and has little family support. Such patients often rely on neighbors, friends and church members to coordinate their medical care. Essential to this is their being able to “call for help” when needed. Patients with advanced cancers who are in the last few days of life may not be in a position to call for help and would greatly benefit from a hospice home.
I believe a hospice home is an essential requirement for the medical needs of the people within Aroostook County. A hospice home will supplement and enhance the end of life services available here. This volunteer effort to create such a facility should be strongly encouraged and supported by everyone.
Arjun Sood, MD
Hematology & Medical Oncology
Aroostook Cancer Care