Hospice director visits Tibet and China
BY MARY LANCASTER
What better place to gain further insight into the respectful, tender treatment of the terminally ill than Tibet, where its Buddhist population holds life in high reverence. Charlene Thurston, executive director of Hospice of Nantucket, recently returned from a 10-day visit to Tibet and China with the People to People Ambassadors Program on a palliative care-specific journey to see their hospitals and care centers for the dying.

Charlene Thurston with the Medical Director of the Song Tang Hospice in Beijing

"People were just fabulous no matter where we were," said Thurston, who traveled with a group of 22 hospice representatives invited from all over the country and led by Cynda Rushton, a nursing professor at Johns Hopkins University.

The program was founded in the 1950s by President Dwight Eisenhower, now run by his granddaughter Mary Eisenhower, to gather factions of caregivers, educators and others in world-wide locations to share their similarities in mission values and needs regardless of their varying cultures and governments in an effort to promote global peace.

Thurston's group visited the Songtang Hospice and a hospital in Bejing, then Lhasa, Tibet where they toured two hospitals with one dedicated to traditional Tibetan medicine, and went on to Chengdu, China to visit a university of traditional Chinese medicine and a hospital. Throughout the trip the group met to exchange information on how each member's organization cares for the dying.

Besides its overall hospice home treatment program, Nantucket's agency has a program called Tapestries, a grief support program for children, and the Caregiver's Connection, a support program for those attending to a terminally ill friend or family member.

During the visit, Thurston learned about integrating Eastern therapies that complement Western methods, such as massage and acupressure she has been working to implement to enhance patient's overall well-being and comfort. She discovered that, particularly in China, that country's quest to become more modernized and model the United States places it at risk of abandoning long-time traditions for the goal of scientific advancement.

"We sort of laughed that we have come here to learn yours," said Thurston. "The idea is to keep what works in our own cultures and integrate what works well in others to have the best of Eastern and Western methods." On the tours, Thurston observed that

traditional hospitals still use herbs, acupuncture and varied massage techniques including something called cupping, a stimulating massage, with little modern medicine involved, and that they treat the elderly with great esteem. She noted that at the Songtang hospice, the group heard patients' whole life stories with the reason they were ill a small, secondary addition, and that the entire staff was involved in lots of playful and social interaction with clients.

"It was something you would never see in this country. It was remarkable. It was all about the person, afforded this level of dignity," said Thurston. "When they would introduce you, they would introduce you to the whole human being. There was light in their eyes. There was no depression."

She also learned about how, in China, the poorest people without government jobs or work providing health insurance must pay out of pocket if they need health care, whereas in America there are safety nets such as Medicaid or hospital free care available, and that there did not appear to be home care services such as hospice so the terminally ill are able to remain in familiar surroundings.

China also avoids informing patients that they have a life-threatening illness in fear that they will give up hope. It was different in Tibet, where a strong, underlying spirituality is an integral part of everyday living and there is a chapel in every home.

What pleased Thurston most was coming away from the trip with an affirmation that the values in this country concerning hospice treatment of the dying and approaches to keeping them in dignity to the end of their lives are respected and emulated.

"The support of body, mind and spirit, not just treating them physically, the support of their families and the importance of continuing to incorporate some of the complementary therapies into our practice are the right values for us," she said. "And truly remembering we are not just dealing with bodies here - we're dealing with people who have history and stories and need to be confirmed in inherent dignity."

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