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"My mother's oncologist referred us to Hospice for the last three months. They came into my home and I know I could not have done it without them. I am a single woman and I need to work for a living. I had to balance everything. It was a trying time to say the least. And they helped me to deal with my grief I had just lost my father to cancer three years before. I used the entire team to work with our whole family. It was absolutely fantastic. Everything that everyone's ever said is absolutely true." Participants felt that they would call Hospice"when the time comes." For some, that was during the final months or even days. For one, this meant at the time of diagnosis. Others felt that they wanted to bring in Hospice earlier on, even though they wouldn't use multiple services later. The group felt that the reasons people often don't contact Hospice until the last days are centered in denial of their illness and a desire to preserve their independence. One participant characterized those feelings this way: "If I give in to the fact that I'm sick, then I'm going to need lots of people around." The goal of Hospice is perceived as pain relief for the patient, mental relief for both the patient and family, and to allow people to die at home as comfortably as possible and in familiar surroundings. They didn't understand Hospice's goal of helping patients make the most of the time left to them. One talked about a friend getting Hospice in at the end of the process but didn't realize they could have helped with preparation and family coping at an earlier stage. "I have a friend who passed away about a year and a half ago. They didn't get Hospice in until the last six or seven weeks. His wife didn't realize that they could be such a help and said `I felt so alone until they came."' One person was concerned that they thought there was a guideline of less than six months to live. The participants who were physicians said that it was very hard to judge how much time remains, even as health professionals. They were pleased to learn that the limit here was actually 12 months. Reactions to In-patient Facility The moderator asked what else they would like to know about Hospice in addition to the funding and fees. One person was concerned about integration with full-time care. She wished Hospice would coordinate full-time care arrangements. She said this was needed because there is no in- patient facility. "I wished they'd been more interconnected, because when both people work or if there's a single person, people have a need for that kind of care." Another wanted to know if he had heard correctly that Hospice had expansion plans. The moderator explained the facility plans under consideration. Their first reactions were positive. One felt that through her work with mobile meals, she was often in contact with people who Chamberlain Research Consultants Page 14