MAKING HOUSE CALLS; DOCTOR, NURSES AID THE DYING THROUGH SOUTHEAST HOSPICE

Malcolm Reddick sat shirtless and puffed on a cigarette as he labored to breathe.

He coughed up blood as he sat at the table in his home at 1438 N. Water. He doesn't eat much. Most days, he is too weak to leave his home.

Reddick, 74, has severe emphysema and lung cancer.

Across town at the Fountainbleu Lodge nursing home, 74-year-old JoAnne Seabaugh is bedridden. Oxygen tubes to her nose help her breathe.

Seabaugh's husband died of lung cancer and now she is too.

Cancer patient Billy Howard, 60, is dying, too.

Outwardly, the former surveyor looks healthy enough as he whittles a piece of wood into a cross outside his mobile home at 1400 S. West End Blvd.

But appearances are deceiving. Howard had a kidney removed in February, but the cancer has spread to his lungs and bones.

Howard, Seabaugh and Reddick are among the terminally ill patients served by Southeast Hospice.

Southeast Missouri Hospital operates the program from a former furniture store at 760 S. Kingshighway.

The hospice has a staff of 16 full- and part-time employees, and about 80 volunteers. It serves patients in Cape Girardeau, Scott, Stoddard, New Madrid, Mississippi, Perry, Bollinger and eastern Wayne counties.

Hospice nurses, social workers and Dr. Charles P. McGinty regularly make house calls.

The hospice staff also includes a minister, who visits patients and families on request.

Hospice staff members dispense everything from emotional support to pain medication.

"Our ambition is to give these people as good a death as possible," said McGinty, Southeast Hospice medical director. "We try to make their last few weeks or months as pleasant as possible."

McGinty plans to close his 40-year-old Cape Girardeau practice by the end of the year and devote more time to the hospice program.

He has worked with the program for about a year, taking over as medical director last summer.

The hospice medicates patients to relieve as much of the physical pain as possible.

Patients are typically prescribed a variety of drugs, including morphine.

The goal is to let the terminally ill die at home or in nursing homes surrounded by their families rather than in a hospital room.

"It is a philosophy of care," said Nancy Bishop, a registered nurse who serves as patient-care coordinator.

"It helps a lot," said Howard during a home visit Wednesday by Bishop and McGinty. "There are things that I can tell Nancy, that I can't tell my wife."

Howard worries how his wife and 9-year-old grandson will cope with his death.

But both Howard and his wife, Betty, said the hospice program has helped reduce their anxiety.

The program deals with both patient and family. Social workers help families fill out insurance forms and even make funeral arrangements.

Hospice volunteers will do light housework, read the Bible or just visit with patients and families.

After the patient dies, social workers counsel family members and provide emotional support through a 13-month bereavement program.

By the time patients enter the hospice program, death is near.

Some patients last only days, others a few months. It is rare for a patient to last a year.

The average is 51 days, said Judy Aslin, hospice services director.

Reddick entered the hospice program July 26.

"He probably won't make it to Christmas," McGinty said. "He may not make it to Thanksgiving."

Seabaugh was diagnosed with lung cancer on Aug. 15. Through the hospice program, she was moved into the nursing home at the end of September. The former dance instructor could live another four months.

Howard, who just entered the program, might survive for six months.

Last year, Southeast Hospice dealt with 94 patients.

From January through September, it has dealt with 117 patients. Most have already died.

McGinty said typically there are about 25 to 30 patients in the program at any one time.

Southeast Hospice started in 1986, but it is still a new idea to many area doctors who are more comfortable treating the living than the dying.

The program used to serve about 20 to 30 patients a year.

But it has seen a big increase in patients since the program was certified by Medicaid and Medicare in July 1993.

Although Medicaid, Medicare and private insurance pay part of the cost of the program, the hospice still depends on donations to meet expenses.

The hospice's four nurses each visit about four patients a day, Monday through Friday.

Some patients get weekly visits. Others are seen more often.

McGinty, accompanied by a nurse, visits five or six patients each Wednesday.

The hospice has a nurse on call 24 hours a day, seven days a week.

McGinty always is accompanied by a nurse.

It is the nurses who regularly visit the patients, although McGinty is responsible for prescribing medicine.

"This is not a doctor-patient program," said McGinty. "This is a nurse-patient program."

Hospice facts

There are more than 2,500 hospices in the nation and Puerto Rico.

Last year, hospices served over 340,000 patients and families.

Over the past five years, the number of hospice patients has increased an average of 16 percent annually.

Hospices care for about one of every three terminally ill cancer patients in America and one out of every three AIDs patients.

In 1992, 78 percent of hospice patients had cancer; 10 percent heart-related illnesses; 4 percent AIDS; 1 percent kidney diseases; 1 percent Alzheimer's; and 6 percent other health problems.

Fifty-three percent of hospice patients are male; 47 percent are female.

Given six months to live, nine out of 10 Americans surveyed in a 1992 Gallup poll said they would choose to be cared for and die in their own home or a family member's home.