Health In th is d iv erse u rb a n a re a, h e a lth deliv ery s y ste m s m u s t serv e th e n e e d s of m an y g ro u p s w h o se c irc u m s ta n c e s in life place th e m a t risk or g e n e ra te s p e cial levels of n eed. T h e C leveland F o u n d a tio n ’s 1981 g ra n t m a k in g d e m o n stra te s how v ib ra n t th e ra n g e of services in th e h e a lth field h ere c an be. T he su c c e ss of sev eral p ro je c ts d o c u m en ted in th is re p o rt d e p e n d s on stro n g e le m e n ts of p e rso n -to -p erso n care a n d c o n ce rn . A h o sp ice p ro g ram is h elping te rm in a lly ill p a tie n ts p re p a re for d e ath in th e fa m iliarity a n d com fort of th e ir ow n h o m e s. S e n io r c itiz en s are going door to door, c h e c k in g on th e h ealth n e ed s of elderly n e ig h b o rs in a n im p o v erished p a rt of th e city. Two fa m ily p ra c titio n e rs are a c tin g o n th e n otio n th a t m a n y h e a lth p ro b le m s of th e ir low- a n d m id d le-in co m e p a tie n ts can be tra c e d to u n h a p p in e s s a t hom e. A nd in a pro ject th a t b u ild s on eig h t y ears of F o u n d atio n w ork in p e rin a ta l care, pro fessors from tw o C leveland u n iv ersities are c o n d u c tin g s em in al research to a s s e s s th e school re a d in e ss of ch ild ren b o rn p rem atu rely . T h ese p ag es also in c lu d e a c c o u n ts of several strik in g a n d e x e m p la ry p ro g ra m s in re se a rc h , te a c h in g a n d h igh technology. C le v ela n d ’s only m edical school is re b u ild in g its w hole basic sciences re s e a rc h a n d te a c h in g c ap ab ility to be in th e forefront of n atio n al re s e a rc h in d isease. A w idely resp ected te a c h in g h o sp ita l, w hich serv es a large n u m b e r of C lev elan d ’s in d ig en t p o p u la tio n , is u n d e rg o in g ren o v ation a n d e x p an sio n . B esides m a k in g n o ta b le c o n trib u tio n s to th e h e a lth sce n e in C leveland, th e m e n a n d w o m e n lead in g th e se efforts m a y well see th e ir in s titu tio n s a n d p ro g ram s b eco m e m o re c o m p e ti tive in th e n a tio n a l a re n a . T he F o u n d ation re m a in s in te n t on h elp in g forge C le v ela n d ’s rich , evolving re p e r toire of h e a lth serv ice s o u t of th e c ity ’s collection of h ig h q u a lity in s titu tio n s a n d people.
P r o je c t G O h: ‘N o th in g g la m o ro u s! s a y s a F o u ndation c o n s u lta n t fo r th is c o m m u n ity self-help effort. ‘J u s t good, d o w n -to -e a rth w ork going on!
H o s p ic e : H e l p in g P a t i e n t s a n d F a m ilie s Cope w ith D e a th Bob, a burly, activ e m a n in his early sixties, learn ed he h a d irrev ersib le c a n cer of th e re c tu m . For th e n e x t two y e ars d o cto rs w ere able to c o n tro l th e disease, b u t th e n Bob b eg an to fail. He a n d h is wife sh a re d resp o n sib ility for eleven c h ild ren from th e ir p rev io u s m a rria g e s. T h e te en a g e rs h a d alw ays b een difficult to discipline, a n d th e c u r re n t fam ily crisis only in creased th e tension. A nxiety in th e h o u seh o ld b ecam e nearly u n b e arab le . W here could th e fam ily tu rn d u rin g B ob’s la st m o n th s? In 1981 Bob w as one of 6 50 te rm i nally ill p a tie n ts in th e a re a w ho tu rn e d to th e H ospice C ouncil for N o rth ern Ohio for a relatively new ty p e of h e a lth care. “ HospiceT a te rm w hich d u rin g th e Middle Ages signified a restin g place for w eary trav elers, now su g g ests special care sen sitiv e to th e n eed s of dy in g p a tie n ts a n d th e ir loved ones. T h e C ouncil, w h ich a c ts as a coordi n a tin g a n d fu n d -raisin g o rg an izatio n for sev en state-certified hospice a g e n cies in G reater C leveland — six hom e care te a m s an d one in p a tie n t facility — co n n ected Bob a n d his fam ily w ith th e hospice reso u rce in th e ir com m unity. O nce assig n ed , th e local team provided a d irectin g p h y sician , a n u rse, a social w orker, a clerg y m an a n d tra in e d v o lu n teer aid es w ho n o t only help ed m ak e B ob’s final six m o n th s com fortable an d free of pain, b u t b ro u g h t his fam ily closer together, offering su p p o rt m o n th s after th e p a tie n t’s death. T he hospice ap p ro ach , now a rapidly grow ing m o v e m e n t in th e U nited S tates, does n o t try to p re v e n t d e ath by focusing on possible cures; in ste ad it seek s to provide a p a tie n t w ith care th a t will im prove th e q u ality of th e life th a t re m a in s. H ospice h elp s a p a tie n t stay in control of h is life a n d in to u ch w ith h is friends, ta k in g p a rt in ev ery day fam ily activ ities a s long as possible in th e e n v iro n m e n t in w hich he feels m o st secure: h is hom e. A ccep tan ce into th e p ro g ram re q u ires so m e to u g h decision m ak in g . T h e p a tie n t an d fam ily — a n d u su ally th e p h y sician — m u s t co n clu d e th a t th e p a tie n t is te rm in a lly ill (usually w ith six m o n th s or less to live) a n d th a t all efforts will b e directed to w ard care a n d relieving sy m p to m s th a t cau se pain, n o t a t h o p eless a tte m p ts to rev erse th e disease.
T h e F o u n d a tio n r e m a in s in te n t o n h e lp i n g f o r g e C le v e l a n d ’s r ic h , e v o l v i n g r e p e r to ir e o f h e a l t h s e r v ic e s o u t o f th e c i t y 's c o lle c tio n o f h ig h q u a l i t y i n s t i t u t io n s a n d p e o p le .
A n x i e t y in t h e h o u s e h o ld b e c a m e n e a r l y u n b e a r a b le . W h e r e c o u ld t h e f a m i ly tu r n d u r in g B o b ’s l a s t m o n t h s ?
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