6. No Preference OPTION Only If the abstract is not accepted for presentation the SPON- Session in which paper might be scheduled (check one box Biomarkers. Diagnosis. Etiology. Epidemiology Clinical Trials DROPERIDOL (DP): OPTIMAL DOSE AND TIME OF INITIATION. Escalating doses of DP were tested for antiemetic I hereby give my permission for Audio-Stats Educational Services, Inc. to record my presentation even at the annual meeting of the Amencag Society of Clinical Oncology for audiocassette sales to attendees and members of ASCO. Signature of presenter VAMC, Oncology Section 50 Irving Street, N.W., Washington, D.C. 20422 (202-745-8178) As the SPONSOR of this abstract, on behalf of all of the authors. I hereby transfer its cops right to the American Society of Clinical Oncology, Inc. (202) 541-6266 arca code, telephone number Please verify that you have adhered to all ASCO abstract submission rules. Infractions of authorship regulations will result in rejection and return of the abstract to the SPONSOR without consideration by the Program Committee. Infractions of format will result in a fee of $30 which will be billed to the SPONSOR. Mr. PRINCIPI. Ms. Dreyer. MS. DREYER. Thank you. I am Sharron Dreyer, assistant administrator, Patient Care Services, Hospice of Northern Virginia. The written testimony that you have before you gives you the facts, figures, and measurable data that we have gathered in our program over the past several years. We have been providing home care for more than 6 years, inpatient care for the last two. We believe that hospice is comprehensive, coordinated care which provides home care, inpatient backup and bereavement followup to families through the first anniversary of a patient's death. What is not included in my written testimony is the soft data or the harder to define, much less measure issues, about quality of life, patient/family satisfaction and the opportunity to deal with bringing one's life to a close in a personal, meaningful way. There are hard to measure intensity levels in the amount of care provided to terminally ill patients to promote hospice goals. It is not uncommon to hear people say, we have been caring for the terminally ill for years and, therefore, we have been providing hospice care. I believe that hospice care is different. It is coordinated, comprehensive interdisciplinary care which deals with patients and their families as a unit. It is provided on a continuum from home care to inpatient care with family support. It is labor intensive. It is personal care. I happened to be at my office on Saturday, which is unusual, working on this testimony and received a call from a young woman from out of State whose mother had died in northern Virginia without the benefit of hospice care, primarily because of misinformation about what hospice care was. This young woman's frustration led her to question me, after a lengthy conversation, as what can I do to see to it that other people do not have to go through what my mother went through: How can I help notify the doctors who are responsible for her care about what hospice care is? My mother would have been a perfect hospice candidate. She wanted to be at home. We were available to provide care for her at home. We were there to be supportive. We lacked information about what hospice was. That is a telling story. Sixty-seven percent of our patients are able to die at home. I think hospice needs to be an option or a choice that patients have and I would encourage this committee to recommend that the VA explore community options for hospice care, that they not only focus on care for terminally ill veterans within inpatient settings, but that they explore community options, that they explore providing hospice care to veterans who are residing in old soldier homes, in personal care homes and whatever other settings they are currently relating to in terms of caring for veterans. I would encourage you to explore creating options to provide hospice care in any or all of those settings. I would like to share with the committee three unsolicited sentences from family members following care of their loved ones. The hospice staff allowed us to make all of the decisions, within reason of course. You were supportive when needed and yet gave us the privacy and intimacy we needed during the last moments of his life. The second young man wrote: I was most impressed with the high level of technical skill and competence of the staff in all departments and at all levels. But beyond professional abilities you provided a warmth and understanding which has been of invaluable help to dad and our family. And the third man wrote: Knowing my brother could not manage for himself, he still wanted to be in charge, and hospice allowed him this freedom. From the first visit to our house for a preadmission visit to the moment the nurses stood with us by his bed as he drew his last breath in sleep and without pain, the hospice staff and volunteers provided a haven of caring, dignified, mature human love for my brother. We are grateful. If we had more time, I could share more of these with you. The main point I wish to make is that I understand the necessity for cost containment. I also know that statistics and research are important. People are important too. I would encourage this committee to explore as many options as possible for providing comprehensive hospice care in whatever settings veterans may be located, in their own home, in the community, in an inpatient setting, if that is appropriate for management of that particular patient, and also I encourage you to support bereavement followup for families. Thank you. Mr. PRINCIPI. Thank you. [The prepared statement of Sharron Dreyer, B.S.N., assistant administrator, Patient Care Services, Hospice of Northern Virginia, Inc., Arlington, VA, follows:] PREPARED STATEMENT OF SHARRON DREYER, B.S.N., ASSISTANT ADMINISTRATOR, PATIENT CARE SERVICES, HOSPICE OF NORTHERN VIRGINIA, INC., ARLINGTON, VA. I am Sharron Dreyer, Assistant Administrator for Patient Care Services at Hospice of Northern Virginia. Hospice of Northern Virginia is a community-based, freestanding, non-profit organization designed solely to provide hospice services to our community. We are licensed by the Commonwealth of Virginia and certified by Medicare as a home health agency. Our inpatient facility is licensed and is Medicare certified as a hospital. We are one of the 26 sites in the national demonstration sponsored by HCFA and are in the process of becoming certified under the new hospice program in Medicare. We also participate in a hospice demonstration under the local Blue Cross Plan, Group Hospitalization, Inc. (GHI), which now offers the hospice benefit to most of its non-Federal contracts based on that demonstration. Hospice of Northern Virginia has six years' experience in providing home care to a geographic area including four counties and five towns and encompassing a population of more than one million in a 100-square-mile area. Criteria for admission to our home care program include residency in our service area no further active treatment for cure life expectancy estimated to be no longer than six months desire and consent of the patient to Hospice care (philosophy, goals and services available) appropriate person to assume responsibility medical, nursing and psychosocial needs that can be adequately and safely met by the Hospice program in patient's residence. Hospice provides a full range of services utilizing an interdisciplinary team approach. Core team members include physician, nurse, social worker, chaplain and volunteer. Additional members may include home health aides/nursing assistants, dietitian, and therapists, such as occupational therapists, physical therapists, speech therapists. Care is provided to patients and their families according to a plan of care that is jointly developed and reviewed frequently. provided in the patient's home if at all possible and our own inpatient facility is available for short-term stays when home care is not appropriate. Bereavement services are available to In our program, care is |