Untitled Document

TOPIC                        :           HOSPICE CARE:   CURE TO CARE
                                                                                  HOSPITAL TO HOME
MODERATOR          :          SEN. LOREN LEGARDA
SPEAKERS             :       SUSAN REYES
                                                HOSPICE OF MANILA EMPOWERMENT
                                                DR. RHODORA OCAMPO
                                                MADRE DE AMOR HOSPICE CARE

SEN. LOREN LEGARDA (LL): This next session is very close to my heart because when my mother was afflicted with breast cancer from 1994 up to 1996, the year of her death, we, at that time we’re somehow ignorant, of how to take care of a breast cancer victim in the family. So it’s very important that we understand how caring for cancer victims is in the home. And our two speakers for today will actually speak about hospice care.

SUSAN REYES (SR): We just want to first share with you a video, it’s entitled “The Patient’s Bill of Rights.” Kara saw this and thought it was a good video to start this segment with and we would like to share it with you first.

Thank you! To be honest, I told Kara when she asked me to talk; this would be very difficult and intimidating for me because to talk about hospice to a group of cancer survivors is something I have never done before. And though I have thought many, many times before about what it must be like to be in the shoes of a cancer patient, there’s just no way I can know and I will not begin to presume to know. It would be such a disservice to all of you who may have had or still have cancer. What I know is what it is to be someone there close to a cancer patient, somebody who has been a so called primary caregiver of one who passed away of cancer. This was my experience.

Like most, if not all people I know who are told that they have cancer, Heny, as well as I, we went on denial because it was the easiest way to cope with the situation. We were both so sure that he will overcome this disease and though he had his physicals regularly, we lived life to the fullest, never thinking that he couldn’t beat this disease. Until the time came when his doctor in San Francisco handed down the verdict and said that “the mestasases has gone into your spinal fluid and brain” and that “you may only have a few weeks, maybe a few months to live.” At that time, frankly, I wanted to slap the doctor for telling that to us in our faces. I thought, “Ang cruel mo naman. How do you know? You’re not God.“ These were some of my thoughts and I was talagang I felt so offended and violated. I was truly, truly more angry than Heny was at his doctor. Galit na galit na galit talaga ako, feeling ko “How dare you tell us that. Who do you think you are?”

In hindsight, I think that this is the kindest and perhaps the best thing he could have done for us at that time, painful as it was. I say it because it made us look at the situation squarely, talked like we never talked before, cried our hearts out together, and then laughed some. He was able to settle personal issues with family and very good friends, ask forgiveness to those who may have unwittingly hurt, tell those he love how much he love them. Most important of all he took the burden off all our shoulders about decisions regarding his care. He told me very clearly, “Darling, under no circumstances will you ever, ever bring me back to the hospital, and whatever happens, do not allow them to put tubes into me.”

Of course I said “Yes,” but I also begged him to have chemo again, even to only extend his life for few months. Sabi ko: “Malay mo, baka may bagong lumabas na treatments next month to cure you.” But he had made up his mind, and though he really wanted to live, I supposed he knew in his heart that it was time, and so he chose quality of life over further so called treatments, not to cure but really just to prolong by only a few more weeks. His only concern was that when his time came he didn’t want to feel like he was drowning due to shortness of breathe, something he used to feel during bad attacks of asthma. So he consulted with his lung doctor who also became our friend – Dr. Jeff Wolden. And he assured us not to worry about it because he said that if and when the time comes, he will be given appropriate medication like morphine and others that will make him feel very comfortable, and not even be aware that he has shortness of breath.

When the time came that taking care of him became more physically demanding and difficult, I asked his doctor, the one I got angry with, what to do. This time I heard compassion in his voice and he kindly told me to call a hospice. I said “Hospice? Ano yun?” In my mind it sounded like a hotel or a motel or something like that. He simply gave me a number to call, told me not to worry, they will explain what they are about and answer all my questions, and they will help me in whatever way they can, and wow! Did they! In many more ways that I ever dreamt possible. Within the hour of my call, the hospice sent to our home in San Francisco a nurse, who evaluated Heny and the home environment. She went quietly about her business, making calls to procure equipment, and what we needed like oxygen tank, hospital bed, private duty nurses, aides, etc. When she was done with all of that, she sat down with me and quietly told me that from now on she will be on top of Heny’s care, which means that she will be visiting regularly, explain what needed to be done, gently told me what’s happening at this point to him, what to expect so we don’t panic, and finally gave a number to call any time of day or night for whatever reason, big or small. She also said that from then on she will be our conduit to his doctors, but I can still contact them personally if it was what I wanted.

Soon after, a very kind social worker came by and took my hand and simply sat with me and asked me how I was. Something no one thought to ask before. You cannot imagine what this was like for me. Though I never felt self pity or anything like that, this little compassionate gesture meant the world to me. It sort of boosted my morale and gave me the fortitude and strength to go on. For the first time in weeks, parang I felt that I, too, mattered. Within about an hour of their arrival, they managed to instill the house with a sense of calm and order in place of chaos, and sometimes even hysterical commotions and going-ons, and because of them, we, his loved ones and family, were able to be that to him – family. We were able to sit with him quietly, provide him with good quality companionship, chat or even just sit beside him, holding his hand and listening to good music. From extensive experience, hospice nurses always know when the moment is near and so when that time came, she gently told us, so that we could all be there with him holding his hand as he passed, keeping him company all the way to his last breath.

In the end, death came to him peacefully, and so quietly, and with so much grace and dignity, so much like how he lived his life. In the midst of my grief, I remember thinking to myself that we were so fortunate to have had the help of hospice. That this service should be able, should be also available in Manila to help make lives of patients, as well as their loved ones easier in this most difficult time. It was just so different from my experience of when I lost my father in an ICU of a hospital here. It was so magulo, doctors and nurses running to and fro, my father hooked up to all sorts of machines and was so full of tubes that there was just no place for us to hold his hand. It was frightful to say the least. Two years later, Dr. Josefina Magno, mother of hospice and recognized founder of hospice in the United States of America, and yes, she is a Filipina, along with some friends like Tessie Escaler, Ching Escaler, Laleng Lim, Annette Sumulong and I, founded Home Inc. a private hospice care provider.

So what is hospice? Simply put it is a concept of care that maybe put in place when cure may no longer be possible. It is a shift from cure to care that can be brought to the patient’s home. Allow me to quote Dra. Magno when she said “The last days, weeks, or months of a patient’s life can be the most meaningful. A time when material issues are handled, relationships reconciled, goodbyes said and spiritual growth experienced.” Further she wrote that hospice care focuses on the relief of these three problems: Pain. Pain in the terminally ill can be controlled, and experience in the St. Christopher’s Hospice in England shows that the study of 10,000 cancer patients who died at St. Christopher’s had their pain controlled except in 5% of these patients. It is just a question of knowing what is causing the pain and then using the right drugs, in the right dose, and in the right method of administration. Pain sometimes is not only physical pain. It can also include social, psychological and spiritual pain. All of which have to be addressed competently and effectively. Loneliness. The pain of loneliness can be as excruciating as physical pain but it cannot be relieved by medication. In hospice care, loneliness is alleviated by the use of volunteers and by involving the family members in the care of the loved ones. Loss of control. In hospice care, the patient is allowed to make all the decisions, big and small, that he is capable of making. He’s made to feel that he is an individual who matters and not just a number on a bed or a name on a chart.

Although we had patients all the time, we did not have enough to keep Home Inc. afloat business-wise. For our goal was not to make a profit or create a lifestyle out of it. No! All we were hoping for really was that it could self-sustain itself and that, if at some point we made a little money, we would channel it to do some kind of foundation so that we could serve also those who could not afford it. Sadly after much financial loss, we made a painful decision to cease operations. The reason I believed we were not very successful is because we were not able to get the support of the medical profession, for one reason or another. Pero napansin naman namin that sometimes, some of the oncologists, only some oncologists, they would recommend patients to us who are at the end of their rope so to speak as far as finances are concerned. In spite of everything, do I believe we need this kind of care? Absolutely, yes! Certainly it may not be for everybody. I make no judgments on people’s choices. Kanya kanyang desisyon, kanya kanyang diskarte. But it should be there for those who may want it. For those who want to die in the peace, comfort, and familiarity of their own homes. It should be there to help family and loved ones take care of their own patient professionally and efficiently in their home so that they can be there as family and even as good friends to that patient. As the Dalai Lama in the Tibetan Book of Living and Dying so succinctly put it and I quote: “No less significant than preparing for our own death is helping others to die well.” This about sums up my experience with cancer and with setting up a hospice. I still think there is a need for hospice in the future but really right now, I don’t know how we can go about it to make it self-sustaining. Thank you.

(LL): We would now want to listen to Dr. Dory Ocampo. She is an EENT but she is also a founding member and a program director of Madre de Amor Foundation. It’s an 11-year old community based hospice and her mother, just like me, died of breast cancer. Dr. Ocampo.

DR. RHODORA OCAMPO (RO): Magandang hapon po sa inyong lahat. Magbibigay naman po ako ng ibang side ng istorya ng hospice. Pero uumpisahan ko po sa isang short video clip tungkol po sa aming foundation. Ang pangalan po nito ay Madre de Amor Foundation. Kami po ay nagbibigay ng hospice care sa Laguna. So can we have the video please?

Narrator: Anita Juliano was in pain, unbearable cancer pain. The cancer began in her breasts, now it is in her bones. Through Madre de Amor Hospice, she was given morphine. She was relieved. Anita is dying. She knows it. She is ready. Any moment, she is ready to face her Creator. Ito ang misyon ng Madre de Amor Hospice – alagaan at samahan ang mga taong may taning na sa buhay at tulungan silang maihanda para sa kanilang kamatayan.

XXX: Ang hospice ay isang konsepto ng pag-aalaga sa mga tao na wala ng kagalingan. Sasabihin ng doctor “wala na kaming magagawa para sa iyo.” Iyon, kami yung tumatanggap ng mga pasyenteng ito. Karamihan ng mga pasyente naming ito siguro mga 90-95% ay dying ng cancer.

Narrator: Madre de Amor Hospice in Laguna began in 1994. The death of young Sarah Katrina Adriano from cancer paved the way for the establishment of the hospice. Sa pag-aaral ng kanyang mga magulang na sina Fermin at Lourdes tungkol sa cancer, nakita nila ang konsepto ng hospice.

XXX: So nung mamatay si Sarah nung August 1992, pagkatapos nyang mamatay, inimbita nila dito sa Los Banos si Dra. Josefina Magno. Sya ay isang Filipina na hospice pioneer sa America. So inimbita nila dito, nagbigay sila ng talk, kung ano yung hospice at from there nagkuha sya ng mga volunteers. Nakasama ako doon.

Narrator: From 8 volunteers in 1994, there are now more than 50 hospice volunteers. The volunteers are mostly senior citizens and retired professionals. They are the heart of hospice. Sila ay may dakilang bokasyon.

XXX: Puwede kang hospice volunteer dito lang sa opisina kagaya yun nga, yung isa kong volunteer, nagluluto lang sya dati, yung isang volunteer inaayos lang talaga yung garden dito. May isa akong volunteer nagta-type lang sya talaga. Yun lang talaga ang gusto nya. May isa akong volunteer nag da drive lang sya. Hindi sya pumapasok sa loob ng bahay ng pasyente kasi natatakot sya. Pero yung pinakamahalaga yung volunteer na nagbibisita sa pasyente, yan talaga lifeline ng pasyente yang volunteer. Linggu-linggo binibisita nya yan. Pine-prepare nya sya spiritually para sa kamatayan.

Narrator: Teresita Gonzales – 64 years old, is one of Madre de Amor Hospice’s pioneer volunteers.

Teresita: We are called the midwives for souls, in the sense na kami yung a group na naghahanda para sa kanila to pass through, to go home to heaven. So sa pamamagitan ng work na ito ay nagkakaroon ng napakalaking grasya para sa sarili namin dahil kung tutuusin, mas kailangan pa namin sila kaysa pangangailangan nila sa amin.

XXX: Ang lagi kong sinasabi “who better to teach you about life than those who are about to lose it.” Pag naka engkuwentro ka at pag naka interact ka sa isang taong malapit ng mamatay, alam nyang mamamatay sya, alam nyang malapit ng mabawian sya ng buhay, ibang pananaw ang makukuha mo sa kanila eh. Pati ikaw, mapa pass on nila yung sa iyo.

XXX: Actually it helps a lot. Unang una it has a developed a new outlook in us. In life, particularly, spiritually, and then of course, it keeps us busy, we are on the move.

Narrator: 72-year-old Soledad Romana also feels the same. When she was not a hospice volunteer yet, she was just spending most of her time gardening.

Soledad: I was just sitting alone sa garden namin. Then naisip ko, hanggang ganito na lang ba ako? Wala na ba akong gagawin kundi itong garden ko na lang na ito. So tamang-tama, alam mo in God’s time, things happen.

Narrator: Hindi lang sa pagbisita sa mga pasyente nakita ang galing ni Tita Sol. Sa hospice din nya nadiskubre na may talento pala sya sa landscaping. Sa katunayan, sya ang nagaayos sa napakagandang garden ng hospice. Antonio Bustrillos finds fulfillment in hospice work.

Antonio: Kita ko nga, as part of our duty as lay minister, we visit sick people. We give communion, distribute communion to them. So, I found out that this hospice has that similar function, and in that way we visit the sick and try to give them hope and enliven their lives so that they will feel that they are still part of the society.

Narrator: The goal of hospice is to ease the pain of dying – pain of the body, the pain of the emotions, the pain of the souls. When the patient accepts death, he begins to be at peace. He reaches out to God – his first and only hope. Kaya naman hindi raw dapat nililihim sa mga maysakit kung sadyang hindi na magagamot ang kanilang karamdaman. Sa pagkamatay di nagwawakas ang buhay, ito’y nagbabago lang. Sa hospice iisa lamang ang pag-asa – ang muling makasama ang Maykapal.

XXX: Alam mo tayong mga Pilipino, ang unang-una kong problema lagi ayaw nilang sabihin sa pasyente na may taning ang kanilang buhay. Ang sagot ko lagi “Naku napakadaya nyo ho. Kayo nakakapag prepare, kayong mga buhay na maiiwan. Paano naman yung mamamatay eh sya itong mamamatay di naman kayo? Sya ang haharap sa Panginoon pag nagkataon. So dapat magkaroon sya ng oras at paraan paano mag prepare.”

Narrator: Hospice service in Madre de Amor is free. Most of the patients are poor, too poor for any treatment but not too poor for pain medication from hospice. We avoid large doses of pain medications. We give low doses regularly to allow our dying patients to be alert, to speak words of love and farewell, to pray. Through the years, Madre de Amor Hospice coverage to continues to expand and reach more cancer patients in barrios, in baranggays, in major cities in Laguna.

Patient: Malaking tulong na yung libre, hindi ako pinababayaan, dinadalaw ako, bahay pa. Eh, minsan hindi nga ako makapunta ng Crossing gawa ng wala akong pamasahe. Eh dito hihintayin ko na lang yung araw ng pagdating, dumating ang hospice.

XXX: Lagi kong sagot dyan “By the grace of God.” Pero really ano, private institutions. 100% private institutions.

Narrator: The patients’ comfort, relief and attainment of peace are more than enough reward for hospice workers.

Patient: Pagka may bisita ako, malibang libang ako. Parang kuwan, ano yung mararamdaman ko. Kamukha ngayon po marami kayo. Pagka nag iisa ako, ang lungkot lungkot ko. Naiisip ko yung kuwan nararamdaman ko na sakit.

Narrator: In doing hospice, we do not set out to change the world. We only want to do something about the pain of dying.

XXX: Syempre iiyak ka din kasi alam mo yung rapport ninyo during the ano, parang tinuturing ka talaga nilang ka pamilya. Sometimes they cannot tell yung mga hinanakit, yung mga ganun. Di nila masabi sa kapatid, sa anak, sa ano nila, but they can tell it to you.

XXX: There are times na we see them dying right before our eyes and kung mahina loob mo eh talagang ikaw ang madadala ng husto. We have to be strong. To be hospice volunteer, you have to be very strong.

Narrator: Sa hospice, di naming hangad ang baguhin ang mundo. Hangad lamang naming ibsan ang hapdi ng malubha ng di na gagaling.

XXX: Dito sa hospice, we live in the promise of God na as long as there is hospice and as long as we are here the volunteers, the spirit of service, yung spirit ng paglilingkod namin will go on and on hanggang sa yun nga hanggang sa bawian kami ng buhay o hindi na namin kaya.

(RO): Thank you! Can we have the Powerpoint presentation? I’ll just show you a couple of slides showing what we really do. So we are Madre de Amor Foundation, a community based hospice. We are in Laguna, I’m sure you are familiar with where Laguna is. The towns in yellow are those areas where we were able to see patients and these are the areas where we have set up hospice centers - Sta. Cruz, San Pablo, Los Banos, and Calamba. So a short history: We began our history 1993 when Sarah passed away from nasopharyngeal cancer and when we started the foundation, what we’re we facing?

That was in 1994. We had difficulty recruiting volunteers, nobody wanted to work with us because they thought that it’s a morbid job. We had no one to look to for training because at that time nobody was “an expert” at it. Of course, the perpetual problem of funding. We want to help but we all know you need money to help. We cannot help without it. Morphine was hardly available in our town and morphine was an essential drug that was needed for hospice care. We had totally no government support. In fact, when our board members called upon the Secretary of Health at that time, he did not know what hospice meant so we had to be the one to explain to him what it was. We had no patients because there was also a lack of committee awareness. And so after 10 years, what have we done? We have expanded our hospice work to 11 of the 30 municipalities in Laguna and established 4 hospice centers. We have trained over 385 volunteers, solicited many donations that’s why we are still here. Morphine is now provided by the Department of Health although it’s not enough, but at least kahit papaano meron. We have assisted 572 patients and their families and we publish quarterly newsletter and a book. We also came out last year with a book entitled “Hospice Stories”.

And of course, I know you know the last person, Mother Teresa. And Mother Teresa says: “We sometimes feel that what we do is just a drop in the ocean, but the ocean would be less because of that missing drop.”

So what does our hospice do? What do we offer our patients? We have pain management, we have symptom control, and we have emotional and psycho-social support, spiritual support. We have bereavement services. We lend them hospital equipment if they need hospital beds, if they need oxygen tanks, if they need nebulizers, we lend them. We lend these out to them for free. And we facilitate networking with various governments and non-government offices because you know, sometimes when you are down there in the economic you know, pole, you are, you don’t have access to all of these or you are afraid to go to the offices. For example, we had one patient who was dying of leukemia. And the office that he was working with had acknowledged that the reason why he got leukemia was because he was spraying insecticides. That was his job. So the office that he worked with acknowledged that this is a work-related leukemia, but his problem was the wife that he was going to leave behind did not read, did not write. So he was afraid that if he died, the office might make loko yung asawa nya kasi hindi nga marunong magsulat eh, hindi nga marunong magbasa, So what we did was he died, the volunteers assigned to him, sinamahan sya doon sa opisina at binasa nilang mabuti yung pipirmahan bago sya pinirmahan nung asawa. And then we advised the wife how to use the money kasi if you’re just going to spend that money naku, isang lingo lang ubos na yun, so what the wife did was nagtirik sya ng tatlong pinto ng maliliit lang naman na apartment and so now she’s okay kahit na wala syang trabaho dahil mahirap nga syang humanap ng trabaho dahil isa ngang no read no write sya, she can provide for their only child.

So this is actually what Kara asked me to talk about. How to organize a hospice in your community. So this is how we did it so I suppose if we can do it in our community, if you want to really do it, you can do it in your community by following a few simple steps. No, not really simple but simple enough.

And lastly, this is my last word to you. And this is from, I can’t even pronounce his name properly, J. Twardowski: ”Let us hurry to love people because they depart so quickly.” Thank you very much.

(LL): I wonder whether hospice care or to put it in simple terms, yung pangangalaga ng may sakit sa bahay – di ba ganun yun? if you simplify it? Is this a new concept in the Philippines? Bago lang ba ito? Is it the first time since Susan started it, what 2 ½ yrs ago and Dr. Ocampo, 11 yrs ago, yours in a very local setting in Laguna and Susan tried to professionalize it in homes. First, is it a new concept and second, are the Filipinos ready for it, and third maybe what we’d like to hear is how affordable is it? So, bakit nyo nagagawang libre, bakit naman yung kay Susan ay nag fold up yung negosyo. Masyado bang mahal? Baka masyado akong maraming tanong pero yun yung basic questions lurking in my mind which I’m sure you’d like to know. Let’s start with Dr. Ocampo.

(RO): Hospice actually started in the Philippines way back in 1989, on an initiative of the Philippine Cancer Society. Yun nga lang hindi masyadong nagkalat at naisiwalat agad so it started with a few groups kaya lang namamatay, nagkakaroon.

(LL): So relatively new? Sanay tayo, i-rush sa ospital o dalhin sa ospital. Kung local hospital man or isang malaking ospital, yung pangangalaga sa bahay or caring at home, and allowing the patient to be cared for by relatives and a professional help is something new. Now from ‘89 to the present, 15 yrs, how has it been? Is it an acceptance of hospice care in the Philippines?

(SR): Sadly, actually we’re having more problems with the medical community than anybody else.

(LL): Ah why? Is it a conflict? Kalaban kayo ng ospital sa negosyo. Ganun ba yun?

(SR): Ah, a little bit. I don’t want to. . . baka may doctor dito magalit sa akin.

(SR): Ah, a little bit like that. Not all the doctors are open-minded on the concept of hospice and palliative care, you know. Yung allowing your patients to be cared for at home. There are about 26 hospices scattered in the Philippines. Most of them are little initiatives like ours, so there are a few based in the big hospitals – Philippine General Hospital has one, Makati had one, but they scrapped the program because of their problems. That’s all. The rest are the community based.

(LL): Maybe Susan can explain to us with a very noble objective of really professionalizing hospice care and investing quite a big amount of money with your friends. Why did it not take off and why did you decide to close shop? Are we not ready for a hospice care?

(SR): First of all, I think the way we did it, that’s why I said we are a private hospice provider. And we were forepaid. We were not like Dr. Ocampo’s group here that is for free. We were forepaid because we promised so much more, I hope she doesn’t mind me saying this, but I think its’ true - we promised a lot more for our patients. Because we were hoping we can get patients who could afford but would really just like to be at home, so we had a lot of doctor’s visits. Our nurses would go visit our doctors, stay there, anytime, many times, sometimes almost everyday depending on the intensity of the care. So that’s why we try to make it a like a business. And I think in that way we were the first, as far as I know, we were the first one to do it that way.

Now, as I said also why we failed is because really we didn’t get the support of the medical profession. We thought that we could get a lot of recommendations from the doctors, because based on what we studied, and also Dr. Magno would always say: “You know in America, hospice was like a continuation of the care of the doctor.” You know, it’s not as if, “O, just because you have cancer and you may be terminal, sorry ka na lang, umuwi ka na, wala na kaming magagawa para sa iyo.” It’s not like that. It should really be a shift to caring. And there are many ways to care for a patient like this. In fact, there are some that even lived longer than a year when in the care of hospice because maraming stress, maraming pain na nare-relieve. Pero because wala nga kaming support from the community, medical community, and really, I think, us Filipinos, I’m sorry, we really find it difficult to talk about things like this. So maybe the doctors may not also be to blame. Maybe it’s difficult for them also to tell a patient the truth. I don’t know. In America I think they have no choice but to tell the truth because they can be sued if a patient, if they don’t tell the truth to patient and then the patient keeps thinking, this is what I know, I could be wrong. And if chemo sila ng mag chemo ng mag chemo yun pala namatay next week, which happens here, I think they can be sued. And here wala naman ganyan eh so.

(LL): Just to give us an idea Susan, magkano ba dapat ang gagastusin o i-a-allocate na funds for hospice care? During the time of your operation.

(SR): One of my business partners is here – Annette. And she’s our financial person. Annette, can you help me?

(LL): Annette Bugarin. I’ve known her for a long time. I did not realize she was into hospice care. I’m glad I didn’t need you.

(LL): Kasi baka meron ka nang sampung kliyente dito, di ba?
Mas mura pala yun kesa pag paospital

(SR): I’ll give you an example. We really try to tailor the care of patient. It would be anywhere from, depende kasi on how sick the patient is. It can be anywhere from P5,000.00 to 10,000.00 a week. But this already includes several doctors’ visits, a nurse visit. Then you can call us for anything.

(SR): Yeah! Sometimes we go pa to Bambang, to buy all your needs, you know, and all your medical requirements and everything.

(SR): All of that. Sometimes it can become a little bit more expensive if for example a doctor sees you 3x a week, then we have to charge you a little bit more. But I will give an example. When we already closed our service, people still call me for help and I recommended one doctor to see this patient at home and they were charged P5000 a visit. So I think we were very reasonable.

(LL): But P5,000.00 a visit from a doctor – medyo mataas ang singil nung doctor.

(SR): Kaya nga sinasabi ko, pero nung homecare, kaya siguro kami nagka lugi lugi na rin kasi hindi kami ganun kalaki mag charge.

(LL): Ayun. So ang nagyari, mahal ang singil ng mga medical practitioners pag hospice care.

(SR): Hindi sila hospice care kasi. Hindi, kasi dapat mag hospice care ang doctor. Medyo ano pa kasi, as she said, medyo vocational. They will do it for (as an advocacy) something like that or out of compassion and everything. And then syempre pag meron din silang back up, like us, the professionals, it’s less tedious for them because may nurse kami na pinapasama sa kanya, merong nagaayos ng mga records, merong you know, may sundo-hatid,

(LL): Okay. Yung mga may medical insurance o kaya covered ng Philhealth, diba marami siguro sa inyo covered ng Philhealth, puwede kaya ang hospice care, Doctora?

(RO): Hindi pa, kasi wala pang out patient benefits ang Philhealth. Once Philhealth accredits out-patient and home care visits, then they will allow it. Pero kasi sa Philhealth, they don’t have funds for that now.

(Q1): Ang question ko ngayon is: Pwede ba yung mga doctors, doctors organizations and nurses, nursing organizations in the Philippines, mag provide ng training sa mga Pilpino na gustong matutong mag alaga ng tama sa mga matatanda at saka sa mga nagaantay lang ng roll call ng Maykaapal.

(RO): Yes, we do actually have a program like that in our foundation. So if you want, you can invite me and I will give you training on how to do that.

(LL): Ah, so you have a pool of doctors and nurses who will be made available for your hospice care?

(Q2): I’m Annie Ruiz, a cancer survivor since 1998, I and Dra. Pacita Abasolo, planned to have a hospice care here in San Andres, Bukid, and I was telling Dra. Ocampo about that. We even went to her place to see…maganda ang lugar nila Dra. Ocampo, kaya nga lang, the only thing is napakalayo. And we wanted to be trained by her. In fact, the reason Dr. Pacita Abasolo and I went to palliative care, because it is also for the hospice. But then it is not yet enough. The experience that we got, and we were able to get some doctors who are willing, to a certain extent. But it is very tiresome, paulit-ulit, pabalik-balik, naturally, they have to live. And they have also to earn money for their family. Those are the reasons na hindi natutuloy.

(LL): Okay. We would like to ask Dr. Ocampo now how you can address that need of Annie.

(RO): Actually, we are available if you need training. You just have to fix the time and place with us. You don’t have to go to Los Baños because we can go to your place. Anyway, you’re just in Manila lang naman, e. It’s not like it’s far away. You organize yourselves, and then invite us over, and we will give you the training there, so that you don’t have to go to Los Baños.

Senator Loren Legarda with Alice Reyes and Dr. Rhodora de Ocampo

posing at the Silver Lining Forum in September 25,2005