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could use the respite care. Others agreed that there certainly is a need. In judging when a doctor might suggest a patient be admitted to the facility, one of the physicians wondered about the length of time the facility would serve each patient. Continuity of care and facility staffing was of great concern for the participants. One of the physicians suggested that a pain management consultant should work in concert with the family physician, because she felt many physicians are not expert at pain management. Another participant suggested that since Madison is a center of pain management, there is an opportunity for this facility to work with the University. Most felt that it was critical to involve the family physician. "As a family doc, I'd like to have a doctor there who knew exactly what they were doing and could advise me and I'd have all the visiting privileges that I'd want and he'd make all the decisions and pump the morphine and tell me how to do it, so that if the patient needed to return home, I could continue care." The facility's staff should also work as a team, not only with doctors and nurses, but also with psychologists, social workers and clergy. Some concern was expressed about the size of the facility. Most felt 14-15 beds would be an ideal size, adding satellite locations if expansion is needed. One suggested a bigger size would start to look like a hospital, which would defeat the purpose of Hospice. Avoiding the hospital feeling, the ideal facility would be small, a home-away-from-home, a place for family to stay, with no "code blues" or crash carts. A central location or several well located small locations were suggested. Some liked a rural type setting not far too from medical facilities and amenities. Someone suggested that accessability meant a bus line or other transportation be available. "When they have sick family, if they're older, they're not going to drive forty miles there and then.drive those forty miles back home crying because it was a bad day." One person wanted to know if there is a market demand for this type of facility. Another countered that pain and monitoring can't always be stabilized at home. They suggested exploring facilities that could be renovated before looking to build. Someone mentioned the old Methodist Hospital downtown. It should be in a more residential setting, according to most. But another cautioned that it shouldn't look like a nursing home because that's where people give up and die. A nursing home has a sense of discouragement. Another agreed, saying the Attic Angels had changed the name of the nursing home to Attic Angels Health Care Center. All agreed that people don't want to go to nursing homes because that's where you go when no one wants you, and it's the end of the road, a place where you will die. "It's solely Hospice. It wasn't like the Hospice people were just going to visit you there." Chamberlain Research Consultants Page 15