When confronted with providing end of life care for a loved one, the family's choice about where to find that care is crucial. Unfortunately, under the current rules in Connecticut, options are very limited. That is why it is crucial that the legislature approve proposed new hospice regulations that would allow the opening of more hospice residences in Connecticut and provide more choice.

The proposal, now under debate in the state legislature, deserves the public's support.

At the end of life most people want to stay in their own homes, surrounded by loved ones. Sometimes this just isn't possible. If a hospice patient can't remain at home they may have to go to a nursing home, or into the hospital. Another choice should be to go into a hospice residence.

A hospice residence provides a home-like environment with specialized hospice care. This is a great option for patients who do not want to go into a nursing home and do not need the type of care provided in a hospital.

However, there are only three hospice residences in the entire state of Connecticut: Stamford, Branford and Middletown. If the patient is not lucky enough to live near one of the three, their family will have to travel from as far as two hours away to visit, or settle for a less attractive setting.

The revised hospice regulations will allow for more residences to be built throughout the state, allowing loved ones to stay locally.

The Connecticut Department of Public Health, with input from the Connecticut Association for Home Care and Hospice (CAHCH) and multiple hospice providers, revised the hospice residence facility regulations that were first written in 1977. The original regulations were written for the hospice residence in Branford (at the time there were no other facilities), and these regulations make it very difficult to build a new hospice residence in Connecticut.

After more than 30 years it is time to approve revised regulations to mirror the Medicare Conditions of Participation, the federal rules that all hospices must follow. The revised regulations would allow for the opening of new residences and focus on the increased need for hospices to evaluate quality, outcomes and compliance. Twenty-eight of the 29 hospices in Connecticut support the revised regulations; CT Hospice in Branford, seeking to protect its privileged position, does not support them.

Approving the revised regulations is vitally important to allow the development of additional hospice residences by licensed hospice programs throughout Connecticut. Having a nearby hospice residence will assure hospice patients and their families easy access to compassionate patient care.

As our population grows, more individuals will choose hospice care during their most vulnerable time. Access to a hospice residence near one's own community must be a choice.

This choice was not available recently to a young adult who lived on his own, yet when struck by a devastating terminal illness could not go back to his home region, near family and friends. He could not go to live with his parent who had to maintain a job. He did not want to go into a nursing home because he was so young. He did not need to stay in the hospital because all of the technology necessary to control his symptoms could be administered in a home setting. But he could not come "home" because he had no choice in our community.

Contact legislators and tell them that supporting the revised hospice facility regulations are what our friends and neighbors deserve to allow them to have the best choices for care in their most desperate time.

Dr. Joseph Alessandro is the medical director of Hospice Southeastern CT, while Carol L. Mahier is a registered nurse and executive director of that organization. Their position is supported by the board of directors.