Annually, Hospice of Martha’s Vineyard (Hospice MV) presents the Spirit of the Vineyard Award to a person, in its words, “whose work has made a difference to individuals and the community as a whole.”
The most recent award, presented at a well-attended ceremony in the West Tisbury library, honored John Early of West Tisbury for his many years of community service.
Were one to apply the same criterion — work that has made a difference — collectively to an Island organization, the fitting recipient would be Hospice of Martha’s Vineyard. Quietly and with no fanfare, often in the most emotionally challenging times of life that an individual and his or her loved ones will face, Hospice MV is there to provide comfort and support. It may be a reassuring hand to hold through a difficult moment, medication meant to ease pain, or advice for those navigating life’s currents.
The four nurses, two bereavement counselors, and approximately 35 volunteers of Hospice MV provide this support seven days a week, at all hours of the day and night.
Since its inception in 1981, its stated mission has been: “To meet the unique physical, emotional and spiritual needs of all who are facing advanced illness and loss, and to give them hope, comfort and compassion. From the beginning, through the journey.”
That Hospice MV does this for free is a testament to its dedicated staff, led by executive director Terre Young, and the generosity of the Vineyard community, upon which it relies for support. No one is denied succor because he or she does not have insurance or the ability to pay.
In turn, by not relying on insurance, Hospice MV is able to provide care unfettered by insurance requirements, and fills a large gap in the health care delivery system.
End-of-life decisions are difficult. Postponing those decisions, or even not talking about them, can have significant consequences for individuals and family members.
At the invitation of the Island’s various councils on aging, Hospice MV leads a conversation on advanced directives and end-of-life care. “That is part of our outreach to the community, and we are very excited to be part of the conversation,” Ms. Young told The Times.
A 500-page report released in September titled “Dying in America” by the Institute of Medicine (IOM) recommended that end-of-life discussions become part of the normal course of health care conversation.
That is not now the case. A national survey in 2013 found that 90 percent of Americans believed it was important to have end-of-life care discussions with their families, yet less than 30 percent had done so.
Key findings in the report include the fact that people nearing the end of life often experience multiple and apparently preventable hospitalizations:
“Of people who indicate end-of-life care preferences, most choose care focused on alleviating pain and suffering. However, because the default mode of hospital treatment is acute care, advance planning and medical orders are needed to ensure that these preferences are honored.”
Incentives under fee-for-service Medicare result in more use of services (hospital days, intensive care, emergency care), more transitions among care settings, and late enrollment in hospice, all of which jeopardize the quality of end-of-life care and add to its costs. In addition, payment silos contribute to fragmentation of care, hinder coordination across providers, and encourage inappropriate utilization.”
The IOM report said, “Efforts are needed to normalize conversations about death and dying. Several social trends suggest that the time is right for a national dialogue on this issue, including health care consumers’
motivation to pursue high-quality care for themselves and their loved ones; a growing willingness to share stories about end-of-life care experiences that resonate across diverse groups; and emerging leadership in local communities as well as national coalitions and collaborations.”
The IOM committee said it “believes a person-centered, family-oriented approach that honors individual preferences and promotes quality of life through the end of life should be a national priority.”
Hospice MV has its priorities in order.
John Early: Vineyard spirit
Intertwined with what you do is who you are. In recognizing John Early’s remarkable array of contributions to our community’s life, extending for more than 40 years — selectman, volunteer fireman and EMT, board member — with the 17th presentation of the Spirit of the Vineyard Award on Dec. 26, Hospice of Martha’s Vineyard celebrated John’s character as well as his service.
As Rich Saltzberg reported last week (Dec. 31, “John Early honored with Spirit of the Vineyard Award”), John’s public contributions have always shown a bias toward getting things done — housing units developed, trails built, land conserved — but never at the expense of careful and thoughtful listening. He has also has been a first responder for 40 years. Watching John discreetly take a call while out to dinner with friends and then slip quietly away to rush to an automobile accident or a fire, knowing the suffering he would have to mediate on behalf of families and friends, was a lesson in community service at its most human and fundamental.
In accepting the 2014 Spirit award, John attributed the long list of challenges he has undertaken to his failure to realize that “no” could be a complete sentence. While that was appropriately self-deprecating, it’s not that John is a pushover; it just isn’t in his nature to turn aside a chance to be useful.