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Aging f mos И 1102 sope Melanne- | Heres info Hugh wathroston your me - Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a publication. Publications have not been scanned in their entirety for the purpose of digitization. To see the full publication please search online or visit the Clinton Presidential Library's Research Room. Duke Institute on Care at the End of Life Opening Doors Access to Care at the End of Life March 2, 2000 Duke University [2 copies] End of Life on Care at the Duke Institute Duke University March 2, 2000 of Life the End Care at Access to OZ-ZATO Duke Institute on Care at the Non Profit Org U.S. Postage End of Life PAID Center for Continuing Education Permit #60 Duke Divinity School Durham, NC Box 90966 Duke Institute on Care at the Durham, NC 27708 (919) 660-3448 [email protected] End of Life is Opening Doors DUKE UNIVERSITY News www.dukenews.duke.cdm Duke News Service (919) 684-2823 FAX (919) 684 5760 Box 90563 Durham, NC 27708-0563 For immediate release Contact: Linda Haac Jan. 12, 2000 (919) 681-8055 [email protected] Note to editors: For phone interviews, you can reach Duke Divinity School Dean L. Gregory Jones at at (919) 660-3434 or at home at (919) 967-5338. The director of the Duke Institute on Care at the End of Life, Dr. Keith G. Meador, can be reached at Duke at (919) 660-3488 or at home at (919) 942-6735. Hugh A. Westbrook is available at his office at (305) 350-5911 or at home at (305) 668- 0444. Dr. J. Richard Williams is available at his office at (305) 350-5923 or at home at (305) 361- 6007 or (828) 743-2644. DUKE UNIVERSITY CREATES NATIONAL INSTITUTE ON CARE AT THE END OF LIFE DURHAM, N.C. - Duke University has received a founding gift of $13.5 million arranged by hospice pioneer Hugh A. Westbrook to establish the Duke Institute on Care at the End of Life to improve research, education and practice across the nation for those near death, Duke President Nannerl O. Keohane announced Wednesday. The new institute will be based in Duke's Divinity School and will have an interdisciplinary focus with a national and international scope. It is the first academic entity in the country to bring together a broad spectrum of disciplines, schools and professions to look at what has become a pressing social issue: how best to care, as a community, for those in the last stage of life. Westbrook is chief executive officer of VITAS Healthcare Corp. of Miami, a 1970 Duke Divinity School graduate and an ordained United Methodist minister. He coordinated the gifts from the Foundation for the End of Life Care, the DadeFund of the Dade Community Foundation and VITAS, the nation's largest hospice provider. "We are grateful for the leadership of Hugh A. Westbrook and VITAS Healthcare in helping Duke to meet a critically important social challenge - providing humane and compassionate care for those at the end of life," Keohane said. "This new institute is an excellent example of the interdisciplinary strength of the university, linking faculty from our Divinity School with colleagues from across the campus and the nation whose research and expertise can help address the complexities of both living and dying well." -MORE- Jan-12-00 12:11P auke news service 681 7334 P.06 care-1stadd "Duke's commitment to developing the world's leading center for the advancement and improvement of care to the terminally ill and their families focuses on one of the most important challenges that can be addressed in human society," Westbrook said. "This generation and all future generations will be able to live a better life knowing that progress is being made on behalf of those we care for at life's end." The new Duke institute will involve the full spectrum of professionals who provide end-of-life care, including physicians and nurses at Duke's medical center, theologians and ethicists from its Divinity School, humanities scholars from its arts and sciences departments, pastors and other caregivers from across the nation, and social work faculty from the nearby University of North Carolina at Chapel Hill. In addition, the institute is in the process of establishing a formal affiliation with researchers and scholars in the Department of Palliative Care and Policy at King's College, University of London, and St. Christopher's Hospice in London, England. St. Christopher's is widely recognized as the site where the modern-day hospice movement began. The institute, moreover, will be a partner with one or more historically black colleges in the United States to address issues of particular relevance to the African-American community. "Issues surrounding end of life care are always significant and increasingly urgent because of changing demographics, economic pressures in contemporary health care, and technological advances tending toward aggressive interventions, "said Divinity School Dean L. Gregory Jones. "In light of these concerns. we need stronger research and improved practice that draws on religious, ethical and socially responsible commitments. "We are excited about the innovative significance of this new institute," Jones added. "Churches and synagogues have long been leaders in caring for people at the end of life, and Duke's Divinity School is well positioned to provide leadership in this area. To deal with complex issues involved in dying well, we need interdisciplinary, inter-school and inter-professional efforts. Hugh A. Westbrook's leadership and founding gifts will enable us to embody our vision for focusing on more effective and faithful care at the end of life." In earning his master-of-divinity degree at Duke, Westbrook specialized in ethics and pastoral care. For the next 10 years, he served as a pastor in North Carolina and Florida and worked as a hospital chaplain caring for terminally ill patients and their families. In 1978, he co-founded with Esther Colliflower the VITAS Healthcare Corp., which provides hospice care to more than 32,000 patients and bereavement services to more than 90,000 people annually across the nation. In 1979, Westbrook wrote and was instrumental in gaining passage in Florida of the nation's first hospice-licensing law and establishing a quality standard for care of terminally ill patients in that state. He has also chaired the National Hospice Education Project, a grassroots effort to promote awareness of hospice care. -MORE- news service 681 7334 P.07 care-2ndadd Activities of the new Duke institute will include academic research and teaching; practical training for health-care providers, pastors and other caregivers; and public information and educational programs for a wider public. Traditionally, Duke has moved to address broad societal issues through multi-disciplinary research. Nearly 50 years ago, the university broke new ground in geriatrics research, establishing the nation's first interdisciplinary Center for the Study of Aging and Human Development. In addition, Duke sponsors the Center for Health Policy, Law and Management through its Terry Sanford Institute of Public Policy. It also conducts the Kenan Ethics Program for the study and teaching of ethics, and has recently established the Center for Medical Ethics and the Humanities in its medical center. "We anticipate programming for the Institute on Care at the End of Life will include research and education on issues such as theological and medical ethics, cultural diversity and pain management," said Dr. Keith G. Meador, institute director and a psychiatrist on both the faculties of Duke's divinity and medical schools. "We also are committed to engaging public-policy issues, particularly as they relate to underserved populations. Although the challenges are significant, we believe an interdisciplinary effort is critical to making substantive improvements in practices related to caring for suffering and dying persons." Meador said he expects the Duke Institute on Care at the End of Life will provide national leadership in training clergy who care for the dying, whether in parish or health-care settings. He also expects the new institute to use hospices across the country to give clinical training to clergy in end- of-life care. In addition, he said, he foresees the new institute serving as a national resource for community and health-care professionals who desire to provide end-of-life care that is attentive to spiritual concerns. The institute will celebrate its founding with a symposium and dinner on Thursday, March 2. at Duke. The symposium, "Opening Doors: Access to Care at the End of Life," will address the virtues and strength of character needed for caretaking, quality-of-life issues for the dying, a patient- and-family centered model of care, and ways to access care for those approaching death. Dr. J. Richard Williams, president of the Foundation for End of Life Care and VITAS executive vice-president, said: "In the 21st century, the most important contributions to the health-care industry will come from the work pioneered by those involved in end-of-life care. Duke's new institute will make a pivotal difference in this care." ----- For more information about the institute or its upcoming symposium, call (919) 660-3537. ----- Jan-12-00 12:10P duke news service 681 7334 P.04 Additional quotes on the new Duke Institute on Care at the End of Life: "Too often in recent years, discussions of end-of-life care have been held captive by the issues of physician-assisted suicide. The institute at Duke offers an exciting opportunity for American society and the caring professions to advance compassionate alternatives to pre-emptive death. It will engender critically needed research into practical, effective ways of responding when suffering persists. Furthermore, the institute will enable us to refine and disseminate techniques for enhancing quality of life, when time is short and every fleeting moment is precious." Dr. Ira R. Byock. author of Dying Well and director of the Robert Wood Johnson Foundation's national program, "Promoting Excellence in End of Life Care." "The Duke School of Nursing is delighted to be a participant in the Institute on Care at the End of Life. The institute emphasizes new interdisciplinary work, bringing together people who provide care at the end of life and those who think about research and policy issues related to the end of life. The institute offers a unique opportunity for us to be leaders in this field and for those at the schools of divinity, nursing and medicine to share work in this critical area with those in the humanities and others across the university." Mary T. Champagne, Duke School of Nursing dean "The Duke Institute on Care at the End of Life will benefit all Americans, but particularly hospice providers, who strive to keep patients free of physical pain and suffering while providing them and their families with emotional and spiritual support. This institute helps move us toward a day when all Americans will better understand their right to quality. compassionate medical attention at the end of life. The National Hospice Organization applauds the establishment of the institute and this life- affirming gift to the nation." Karen Davie, National Hospice Organization president "Social workers are involved in a variety of health settings as members of interdisciplinary teams providing care to individuals and families who are dealing with end-of-life issues. Because it is increasingly recognized that the psycho-social needs of the dying are often as important as their physical care, there is a tremendous need for interdisciplinary research efforts aimed at increasing our understanding of how to reduce suffering and improve quality of care. The new Duke Institute on Care at the End of Life represents an exciting development in this field. The School of Social Work at the University of North Carolina at Chapel Hill is delighted to be involved as a collaborative partner." Richard L. Edwards, dean of the University of North Carolina at Chapel Hill School of Social Work -MORE- 0an-12-00 12:11P auke news service 681 7334 P.05 quotes-1stadd "The quality of end-of-life care is a test of the humanity of the health-care system. It is wonderful that a prestigious school like Duke is undertaking to provide leadership in examining and improving this crucial aspect of medical care." Jack Gordon, Hospice Foundation of America president "Care at the end of life is of growing importance worldwide. This is an exciting initiative, which I hope will help take care forward, and benefit patients and their families through interdisciplinary research and education into ways to improve the quality of care, including access to care and the management of symptoms. We could learn so much by comparisons between the systems in different countries." Irene J. Higginson, palliative-care researcher and professor at King's College and St.Christopher's Hospice in London. "With the institute, we have the opportunity, and indeed the responsibility to approach these matters, and their complex cultural, social and medical dimensions with compassion as well as intelligence. I am particularly excited about the exemplary model of interdisciplinarity the initiative represents. It emerges from a broad and deep curiosity and expertise across the university. What is compelling to each of us is that even at this edge of a technologically savvy age, there is so much yet to be understood about death and dying. It is a subject that dramatically compels our respect." Karla F. Holloway, dean of humanities and social sciences at Duke, and professor of English and African-American studies "This new institute presents a wonderful opportunity for Duke's School of Medicine to collaborate with colleagues in the Duke Divinity School on a range of issues related to care at the end of life. We are excited about what this new program brings to Duke University, and we look forward to working with Dean Jones and others on this important initiative." Dr. Edward W. Holmes, Duke School of Medicine dean "Our research with patients about the attributes of a good death has taught us that spiritual completion ranks second only to pain control. The Duke Institute on Care at the End of Life creates a unique bridge from the Divinity School to the medical center to promote scholarship, education and clinical innovation in pursuit of a truly integrated approach to the dying patient." Dr. James A. Tulsky, Duke associate professor of medicine and director of the Program on the Medical Encounter and Palliative Care at the Veteran's Administration Medical Center in Durham. ### Duke University DURHAM NORTH CAROLINA 27708-0966 THE DIVINITY SCHOOL TELEPHONE 9191 660-3456 OFFICE OF EXTERNAL RELATIONS FAX 919) 660-3405 January 5, 2000 Dr. J.R. Williams, Chairman and President The Foundation for End of Life Care VITAS Hospice Charitable Fund 123 S.E. 3rd Avenue, PMB:110 Miami, FL 33131-2003 Dear J. R.: I want to express my heartfelt appreciation for the commitment by the Foundation for End of Life Care of $10 million over ten years for the Duke Institute on Care at the End of Life. You are providing extraordinary resources that will make a decisive. positive difference for professional caregivers, families, and especially those who are dying. I feel wonderfully privileged to have been involved over the years in the evolution of the Institute, and I am profoundly grateful for the leadership and energy that you are giving to this vital endeavor. May your New Year be filled with peace and joy! Sincerely, we Wesley F. Brown WFB:mws c: Dean L. Gregory Jones [email protected] Institute seeks to illuminate the end of life [01/13/2000] Page 1 of 2 Access: foa9qg89 Status: A Subject: death Subject: medicine Subject: Duke Section: News Paper: The News and Observer Edition: Final Raleigh N.C. Date: 01/13/2000 Page: B1 Headline: Institute seeks to illuminate the end of life ###End Headline Byline: Catherine Clabby Source: Staff Writer Text: DURHAM -- With medicine's success at beating back disease, it forgot something basic. It forgot the value of a good death. Now a new institute at Duke University's divinity school wants to teach everyone from physicians to clergy that death is a natural part of life. And that they must help others make their final journey with dignity. "We're still a culture that wants to deny death,' said L. Gregory Jones, dean of the divinity school. "In medicine, there's a significant bias toward curing. If we haven't been able to cure, we've failed." Duke alumnus Hugh A. Westbrook, co-founder of a large hospice corporation, raised $13.5 million to create the Duke Institute on Care at the End of Life, the largest gift ever to the divinity school. He became interested in how people near death get treated while a divinity student working on cancer wards at Duke Hospital in the late 1960s. Many patients were given experimental treatments to try to extend their lives even though they wanted to leave the hospital and die in peace, he said. No one had asked their wishes. "Few people around them were equipped to have simple conversations that were frank and candid and asked them what they wanted to do," Westbrook said. During assignments at two churches in Eastern North Carolina, he saw that families have much more control over loved ones' deaths. People died at home, their wakes were conducted at home, and often they were buried on family land. "There was no mistaking that a death had occurred in the family, he said. After returning home to Florida, Westbrook became a pioneer in this country's nascent hospice movement. In Dade County in 1976, he and a nurse founded a nonprofit hospice that is now for-profit VITAS Healthcare, the largest provider of hospice services in the United States. Hospice care combines pain control and social and spiritual support for patients and families confronting death, the very things research has shown people want when a family member is terminally ill, said Jones, the Duke dean. "Reaching a state of peace with oneself and God and others ranks only behind pain control in terms of how people define what was a good death for a loved one," he said. But the institute won't focus solely on improving access to hospice care, which after years with an altruistic reputation has come under increased scrutiny by federal officials on the lookout Institute seeks to illuminate the end of life [01/13/2000] Page 2 of 2 for health fraud. "We've got to figure out what the best means for caring for different folks is, said Dr. Keith Meador, a Duke psychiatrist and director of the new institute. Westbrook had been shopping for years for a home for a center that could pursue both research and improved care for the dying, topics that are beginning to attract more attention nationwide. The fact that Duke can implement some of its findings in its massive health system made it an attractive location. "This will not be an ivory tower," Westbrook said. The divinity school will work with students and faculty at Duke and the University of North Carolina at Chapel Hill. It also will seek out a relationship with at least one historically black college in an effort to better understand barriers to dignity in death confronted by African-Americans. And it will work with researchers and teachers in England, where palliative care is more widely accepted than here One goal of the institute will be simply to educate people that they have more options than they realize when confronting death. "Up to now, there have been two choices: either aggressive intervention up to the dying day or Jack Kevorkian and physician-assisted suicide, " Jones said: "There can be a third way between those two." ###End Text fhatveb2getdoc+nao_public_archive+nao_00+1857+0++%28Hugh%20Westbrook%29%3-1/206/200 Duke University Burham North Carolina 27708-0001 OFFICE OF THE PRESIDENT TELEPHONE (919) 684-2424 BOX 90001 January 11, 2000 FACSIMILE (919) 684-3050 Dear Friends of Duke University: As many of you know so well, care at the end of life is one of our contemporary society's most pressing issues. Among the many questions facing us are: How can we be involved in end-of-life care, as family members, friends. clergy, health-care providers, social workers or legal counselors? How can we provide the best possible care for those who suffer or are near death? At Duke, we believe that responding to these critical questions calls for a broad-based inquiry into the many complex aspects of death and dying. Given the urgency and significance of this need, we are establishing a new Duke Institute on Care at the End of Life. This university-wide, interdisciplinary institute will be based in our Divinity School, and will reflect the contributions of scholars and students from across Duke, in partnership with other universities and institutions in the United States and around the world. The institute's mission involves collaborative research, cross-disciplinary education and practical training for caregivers in North Carolina and throughout the nation. Through the leadership of the Divinity School and the Rev. Hugh A. Westbrook, a 1970 Divinity School graduate, grants totaling $13.5 million will support the institute's important work. The grants come from two philanthropic foundations and VITAS Healthcare Corp., a hospice provider based in Miami, Florida. Rev. Westbrook is an ordained United Methodist minister and founder of VITAS and its CEO. We are grateful for his leadership and that of VITAS in helping Duke meet this critically important challenge. Duke's vigorous commitment to interdisciplinary study, coupled with outstanding strength in theology, medicine, nursing, public policy, arts and sciences and law, will prepare the new Duke Institute on Care at the End of Life for international leadership. The institute will be an integral part of the Divinity School's new program in Theology and Medicine, which provides for an annual named lecture in pastoral education, as well as a new joint program offered in conjunction with Duke's School of Nursing. The new Health & Nursing Ministries graduate program offers three options to prepare nurses as international and national leaders in the delivery of health care and parish nursing within their faith communities. The first class of students is scheduled to enter Duke in Fall 2000. The Duke Institute on Care at the End of Life will hold an inaugural symposium, "Opening Doors: Access to Care at the End of Life," on Thursday, March 2, from 1-6 p.m. The symposium is designed for participants from across the nation who work across a range of caregiving activities, including clergy, physicians, nurses, physician assistants, palliative-care specialists, hospice professionals and social workers. Grief counselors, psychologists, family counselors and other caregivers will also find the symposium helpful. Please look for a copy of the "Opening Doors" brochure and registration form in your mail in the near future. I know that you will join the rest of the Duke community and me in celebrating the new Institute and its work. Yours sincerely, Name 0. laman Nannerl O. Keohane Buke University DURHAM NORTH CAROLINA 27708-0968 The Blubility School January 10, 2000 TELEPHONE (919) , 660 3434 Office of the Dear FACSIMILE (819) 660.3474 The Reverend Hugh A. Westbrook Chairman and Chief Executive Officer Vitas Healthcare Corporation 100 South Biscayne Boulevard Miami, FL 33131 Dear Hugh: As we put the finishing touches on Duke's press release announcing the formation of the Duke Institute on Care at the End of Life, and prepare for the public unveiling of this important initiative, I want to pause and give thanks for all of the leadership you have provided in making this dream a reality. I know that an Institute like this has been a dream of yours for two decades, and it has been a privilege to become a part of that dream over the past two years. Your vision and hard work have been extraordinary throughout this process. You have devoted a good portion of your life to providing more effective and faithful care to persons at the end of life, and your exemplary leadership has made a pivotal difference. It is an honor for Duke University, and for me, to play a role in continuing this important work. I hope and believe that the Duke Institute will genuinely embody the vision of your initial case statement, as well as the beautiful description in your letter of January 7, 2000, indicating the extraordinary commitment of $2.5 million from Vitas Healthcare Corporation. I look forward to working with you, J.R., and others to ensure that the Institute makes the significant difference that we both believe it will. On a personal note, I want to tell you what a profound pleasure and joy it has been for Susan and me to get to know you and Carole. You are a joy to be around, and it is fun to work, laugh, and eat together! We are grateful, more than you can imagine, for your friendship and support. We look forward to the celebration on March 2, 2000, and the formal beginning of what I believe will be the most important and significant initiative that will occur at Duke during my tenure. Jey Grace and Peace, L. Oregory Jones Dean of the Divinity School and Professor of Theology P.S. I am enclosing a copy of the memorandum I sent to our colleagues on the Board of Visitors. EOVE BLSE 099 616 ALINIAIC OFFICE SNV3C 6:91 (NOW) 00 01 NAME Duke University DURHAM NORTH CAROLINA 27708.0968 The Divinity School Office of the Boan TELEPHONE (919) 660 3434 MEMORANDUM FACSIMILE (919) 660 3474 DATE: January 10, 2000 TO: Duke Divinity School Board of Visitors FROM: L. Gregory Jones Sker RE: Duke Institute on Care at the End of Life I am very pleased to announce the formal commitment of gifts coordinated by our Board colleague and Divinity School alumnus Hugh Westbrook and his company, VITAS Healthcare Corporation, of $13.5 million for the Duke Institute on Care at the End of Life. This remarkable contribution positions us for a profound and continuing positive impact nationally and internationally on the fundamental issue of end of life care. Based in the Divinity School, the Duke Institute on Care at the End of Life will be an interdisciplinary and inter-school enterprise engaging the intellectual resources of the entire University, as well as other institutions. It will be an integral part of the Divinity School's program on Theology and Medicine. The Institute will help clergy, physicians and other healthcare providers, social workers, and family members better understand and care for the needs of persons who are dying. It will emphasize across the nation and world better research, education, and training for diverse professionals and caregivers. And it will engage the social, legal, and religious communities in such issues as access to healthcare, the meaning of suffering and dying, and the significance of living and dying well. The news release copy enclosed provides additional information. You will want to anticipate invitations to the inaugural symposium on March 2 and the dinner that evening for the celebration of the founding of the Duke Institute on Care at the End of Life. Former First Lady Rosalynn Carter will speak at the dinner. Our spring Board of Visitors meeting will follow on March 3-4. In the meantime, I am grateful for your taking opportunities as a member of our Board to help to celebrate and interpret this remarkable endeavor and the generosity of Hugh Westbrook that is making it possible. Thanks for all of your support of our work at Duke Divinity School, and especially for your friendship. Happy New Year! PAGE 2 3455 099 616 DEANS OFFICE DIVINITY 6191 (NOW) 00 01 NY Duke University DURHAM NORTH CAROLINA 27708-0966 THE DIVINITY SCHOOL TELEPHONE (919) 660-3456 OFFICE OF EXTERNAL RELATIONS FAX (919) 660-3405 January 5, 2000 Dr. J.R. Williams, Chairman and President The Foundation for End of Life Care VITAS Hospice Charitable Fund 123 S.E. 3rd Avenue, PMB:110 Miami, FL 33131-2003 Dear J. R.: I want to express my heartfelt appreciation for the commitment by the Foundation for End of Life Care of $10 million over ten years for the Duke Institute on Care at the End of Life. You are providing extraordinary resources that will make a decisive, positive difference for professional caregivers, families, and especially those who are dying. I feel wonderfully privileged to have been involved over the years in the evolution of the Institute, and I am profoundly grateful for the leadership and energy that you are giving to this vital endeavor. May your New Year be filled with peace and joy! Sincerely, we Wesley F. Brown WFB:mws c: Dean L. Gregory Jones [email protected] VITAS® ® VITAS HEALTHCARE CORPORATION 100 South Biscayne Boulevard Miami, Florida 33131 Telephone 305 374-4143 Fax 350-6784 Website www.VITAS.com Dear VITAS Employee: For decades hospice has bemoaned inadequate end of life education for health care providers. All of us, in every discipline, experience daily frustration and concern about millions of individuals who could benefit from hospice if only they knew. And in recent years all hospice programs, including VITAS, have experienced reductions in length of stay that interfere with our ability to meet even the most basic end of life needs of patients and families. As a hospice leader, VITAS has decided to do something about it. Through the VITAS Hospice Charitable Fund, the Dade Fund of the Dade Community Foundation and VITAS, we are making a founding gift that will create the nation's first interdisciplinary institute to focus exclusively on end of life issues. The Institute on Care at the End of Life will be housed in the Duke University School of Divinity and affiliated with Duke's medical school and graduate school of nursing. But the interdisciplinary collaboration doesn't stop there. The Institute will also work closely with the Department of Palliative Care and Policy at University of London's King's College and St. Christopher's Hospice, generally recognized as the founder of hospice. With our financial commitment and guidance, the Institute will be involved in research, practical training for caregivers and information for the general public. In order to assure the involvement of the full spectrum of professionals providing end of life care, the Institute will work with other U.S. colleges as well. Those colleges include the School of Social Work from University of North Carolina at Chapel Hill and the undergraduate School of Nursing from Central Carolina University. The Institute plans to partner with this historically African-American college to address today's general lack of access by ethnic minorities to hospice care. We are genuinely thrilled by the prospect of what this Institute can accomplish and how quickly they will be able to transfer research findings into real and tangible practice that helps all hospice patients. The commitment to develop the world's leading center for the advancement and improvement of care for the terminally ill and their families focuses on one of the most important challenges that can be addressed in human society. This generation and all future generations will be able to build a better life, knowing we are making progress in the way we provide for a healthy death as those we care for come to life's end. We don't forget for one second that the ability to make this significant commitment is a direct result of your good work. It is your compassionate care for patients and their families at the most important time of their lives that prompts families to make contributions to the VITAS Hospice Charitable Fund. So as we share this thrilling news. we want to thank each and every one of you for your role in this first-of-a-kind endeavor. There will be more news shortly about the VITAS Charitable Fund, the Foundation for End of Life Care and the myriad of issues it will address (including Special Needs). But today we wanted to say thank you. Thank you for your direct contribution to a better end of life for your patients and families. And thank you for your indirect contribution to an improved end of life for millions more. With warmest regards. Tone Colliflowe INNOVATIVE HOSPICE CARE Hugh A. Westbrook Esther Colliflower Vol. Dialogue 14 No. 29 January 14, 2000 Reclaiming wetlands A Duke Wetland Center project will reclaim a degraded portion of the Sandy Creek area near the Duke cam- The Last Days pus. Page 11 Duke creates national institute on care at the end of life by Linda Haac national and international scope. It is Duke University has received a Foundation for the End of Life Care, AIDS care the first academic entity in the country founding gift of $13.5 million arranged the DadeFund of the Dade Community to bring together a broad spectrum of by hospice pioneer Hugh A. Westbrook Foundation and VITAS, the nation's A new NIH grant will help researchers disciplines, schools and professions to at Duke and UNC-Chapel Hill expand to establish the Duke Institute on Care largest hospice provider. look at what has become a pressing treatment for people with HIV. at the End of Life to improve research, "We are grateful for the leadership social issue: how best to care, as a education and practice across the of Hugh A. Westbrook and VITAS Page 4 community, for those in the last stage nation for those near death, Duke Healthcare in helping Duke to meet a of life. President Nannerl O. Keohane critically important social challenge - Westbrook is chief executive officer announced Wednesday. providing humane and compassionate of VITAS Healthcare Corp. of Miami, The new institute will be based in care for those at the end of life," a 1970 Duke Divinity School graduate Duke's Divinity School and will have Keohane said. "This new institute is an and an ordained United Methodist min- an interdisciplinary focus with a excellent example of the interdiscipli- ister. He coordinated the gifts from the (See CARE, page 6) End of life issues draw researchers' interest (CARE, from page 1) toward aggressive interventions," said Divinity Traditionally, Duke has moved to address broad nary strength of the university, linking faculty from School Dean L. Gregory Jones. "In light of these societal issues through multi-disciplinary research. our Divinity School with colleagues from across the concerns, we need stronger research and improved Nearly 50 years ago, the university broke new campus and the nation whose research and expertise practice that draws on religious, ethical and socially ground in geriatrics research, establishing the can help address the complexities of both living and responsible commitments. nation's first interdisciplinary Center for the Study of dying well." "We are excited about the innovative significance Aging and Human Development. In addition, Duke "Duke's commitment to developing the world's of this new institute," Jones added. "Churches and sponsors the Center for Health Policy, Law and leading center for the advancement and improvement synagogues have long been leaders in caring for peo- Management through its Terry Sanford Institute of of care to the terminally ill and their families focuses ple at the end of life, and Duke's Divinity School is Public Policy. It also conducts the Kenan Ethics on one of the most important challenges that can be well positioned to provide leadership in this area. To Program for the study and teaching of ethics, and has addressed in human society," Westbrook said. "This deal with complex issues involved in dying well, we recently established the Center for Medical Ethics generation and all future generations will be able to need interdisciplinary, inter-school and inter-profes- and the Humanities in its medical center. live a better life knowing that progress is being made sional efforts. Hugh A. Westbrook's leadership and "We anticipate programming for the Institute on on behalf of those we care for at life's end." founding gifts will enable us to embody our vision Care at the End of Life will include research and The new Duke institute will involve the full spec- for focusing on more effective and faithful care at the education on issues such as theological and medical trum of professionals who provide end-of-life care, end of life." ethics, cultural diversity and pain management," said including physicians and nurses at Duke's medical In earning his master-of-divinity degree at Duke, Dr. Keith G. Meador, institute director and a psychi- center, theologians and ethicists from its Divinity Westbrook specialized in ethics and pastoral care. For atrist on both the faculties of Duke's divinity and School, humanities scholars from its arts and sci- the next 10 years, he served as a pastor in North medical schools. ences departments, pastors and other caregivers from Carolina and Florida and worked as a hospital chaplain Meador said he expects the Duke Institute on Care across the nation, and social work faculty from the caring for terminally ill patients and their families. In at the End of Life will provide national leadership in nearby University of North Carolina at Chapel Hill. 1978, he co-founded with Esther Colliflower the training clergy who care for the dying, whether in In addition, the institute is in the process of estab- VITAS Healthcare Corp., which provides hospice care parish or health-care settings. He also expects the lishing a formal affiliation with researchers and to more than 32,000 patients and bereavement services new institute to use hospices across the country to scholars in the Department of Palliative Care and to more than 90,000 people annually across the nation. give clinical training to clergy in end-of-life care. In Policy at King's College, University of London, and In 1979, Westbrook wrote and was instrumental in addition, he said, he foresees the new institute serv- St. Christopher's Hospice in London, England. St. gaining passage in Florida of the nation's first hos- ing as a national resource for community and health- Christopher's is widely recognized as the site where pice-licensing law and establishing a quality stan- care professionals who desire to provide end-of-life the modern-day hospice movement began. dard for care of terminally ill patients in that state. care that is attentive to spiritual concerns. The institute, moreover, will be a partner with one He has also chaired the National Hospice Education The institute will celebrate its founding with a or more historically black colleges in the United Project, a grassroots effort to promote awareness of symposium and dinner on Thursday, March 2, at States to address issues of particular relevance to the hospice care. Duke. The symposium, "Opening Doors: Access to African-American community. Activities of the new Duke institute will include Care at the End of Life," will address the virtues and "Issues surrounding end of life care are always academic research and teaching; practical training strength of character needed for caretaking, quality- significant and increasingly urgent because of chang- for health-care providers, pastors and other care- of-life issues for the dying, a patient-and-family cen- ing demographics, economic pressures in contempo- givers; and public information and educational pro- tered model of care, and ways to access care for health technological advances tending grams for a wider public. those approaching death. Gift funds study of end-of-life care - Thursday, January 13, 2000 Page 1 of 3 CLICK HERE to find the best kep THE CHRONICLE online Gift funds study of end-of-life care Greg Pessin current issue A $13.5 million donation will establish Duke as a national January 13, 2000 leader in improving medical and pastoral care for the dying. Issue A $13.5 million gift arranged by hospice innovator Hugh Westbrook, Archive Listing Divinity '70, will establish an interdisciplinary institute at Duke to study and promote compassionate care of patients in the last stages of life, President Nan Keohane announced late Wednesday afternoon. main Westbrook organized gifts from the Foundation for the End of Life Care, Today's lews the DadeFund of the Dade Community Foundation and VITAS Healthcare, the hospice provider he co-founded in 1978. Archives Using a three-pronged approach-training, public education and research Reference Desk and teaching-the Duke Institute on Care at the End of Life will address the ways in which caregivers, from pastors to surgeons, can best attend Search to the dying elderly. Emeprint "I would hope the institute would have direct influence so that in 20 Feedback years from now, we would see changes in terms of public policy and care at the bedside as well as a deeper and more effective understanding of what it means to die well," said Divinity School Dean Gregory Jones. The institute's work will focus mostly on bringing together the issues- religious, financial and medical-involved in medical decisions for dying patients and their families. "Good pain management from the medical side allows for patients to deal with the end of life and.. the spiritual and other issues," said institute director Dr. Keith Meador, an associate clinical professor of psychiatry. "On the other side, family and spiritual care will promote better pain management." Since Westbrook founded VITAS, the company has grown into the largest hospice care provider in the United States, serving 32,000 patients each year-more than four times its closest competitor. Westbrook, an ordained United Methodist minister and now CEO of VITAS, lives in Miami. "This will be the first comprehensive institute of its kind that will address areas with care at the end of life," Westbrook said. "That says a lot about the status of end-of-life care. It is something that happens every http://www.chronicle.duke.edu/chronicle/2000/01/13/01Giffundshtml 1/26/2000 Gift funds study of end-of-life care - Thursday, January 13, 2000 Page 2 of 3 day and we avoid talking about every day Duke's willingness to not only study and teach but to commit itself to delivering end-of-life care are the important elements that make Duke the unique place for the institute to be created." In addition to doctors and nurses from the Medical Center, theologians and ethicists from the Divinity School and humanities experts from arts and sciences departments, the institute will involve a few new faculty hires both inside and outside the Divinity School. The center will also work collaboratively with pastors and caregivers around the country and social work professors from the University of North Carolina at Chapel Hill. In other words, caregivers from across the nation will have different levels of commitment to the institute's work-while some will research, teach and train for the institute full time, others will consult with the core staff at the University. In the next few months, the institute will establish ties with a historically black college or university to help it address issues of unique relevance to the black community, which has largely been neglected by the hospice industry. There are also plans to affiliate with the Department of Palliative Care and Policy at King's College at the University of London and London's St. Christopher's Hospice, where the modern-day hospice movement began. The institute's first program, the March 2 symposium "Opening Doors: Access to Care at the End of Life," will draw to campus experts from around the nation to discuss accessibility of end-of-life care, quality-of- life issues, a patient-and-family caregiving model and the character virtues needed to be an effective caregiver. Ultimately, organizers hope that the seminar's findings would be widely disseminated, like the research the institute will eventually produce. By formulating a public relations strategy to bring research to mass media and professional journals, the institute will make education a major part of its work. Later in the year, a seminar in Washington D.C. will address the problem as it relates to public policy and the community, and is meant to attract ordinary citizens as well as politicians. "This is quite a large gift for a divinity school program, maybe the largest I've ever seen nationally... said John Burness, senior vice president for public affairs and government relations. "It tells you how big and complex the issue is." 1. 1998 The hronicle / Duke niversity / comments a www.chronicle.duke.edu http://www.chronicle.duke.edu/chronicle/2000/01/13/01Giffunds.html 1/26/2000