DYING DIFFERENTLY

Editors, Vineyard Gazette:

As with the Moshup Trail heathlands, Hospice of Martha’s Vineyard is a rare and unique species in our world today. It deserves the same kind of consideration and intentional support to preserve its place in our community.

At some level it is a relief to have this conflict out in the open. The aggressive position of the Vineyard Nursing Association (VNA) toward Hospice of Martha’s Vineyard has been a simmering pot for at least a decade. As a former employee of Hospice I was aware of the VNA’s desire to control end-of-life care and their often-voiced opinion that they provide the same level of care and service as Hospice of MV. That simply isn’t possible.

Hospice care is now recognized as a clinical specialty. While all medical personnel are expected, and should be able, to attend to the dying with skill and respect, there is a demonstrated need to have professionals available who are particularly educated — and experienced — in complex symptom management, grief and loss, and the dying process. At the end of life people need caregivers who recognize the signs of death and most importantly, are willing to communicate that information to the patient and their loved ones. Not everyone is suited to this task.

When providing end-of-life care Hospice of Martha’s Vineyard has always worked in partnership with the larger care-giving community. By accessing the full range of resources available — including the patients’ active relationships with all of their caregivers as part of the ‘team’ — the needs of dying patients and their families have been successfully met for the past 28 years. I don’t understand the logic in thinking the current model of care needs to be changed.

During my time with Hospice I was always bewildered about why it was so much easier to share a case with the Visiting Nurse Service (formerly with Martha’s Vineyard Community Services). They seemed to welcome our involvement, respect the different skills we each brought to the situation, and the added benefit of mutual support among the staff. We worked collaboratively rather than competitively. I could only conclude that the culture, or leadership, at the VNA was unable to perceive Hospice of Martha’s Vineyard as an expansion of their care rather than a hindrance to their independence.

Many people in the community may believe that Medicare certification for hospice care is money out there for the taking, and well, why not? Anyone who works in health care today — and understands the Medicare reimbursement system — can attest to the fact that caregivers now spend as much time doing paperwork as they do caring for patients. Identifying what Medicare will pay for or not pay for, under which specific conditions and for what amount of time — and you must be able to prove it all many times over — is a mind-numbing endeavor, none of which should be imposed on any patient or family, frankly at any point in life, much less when someone is facing a life-limiting illness.

The hospice “movement” — and Hospice of Martha’s Vineyard — was a response to the need to tend to dying differently — philosophically, medically and bureaucratically. The hope was that perhaps, at this one time in life, the payment source — and the limitations of what that source will pay for — should not be an issue or even part of the discussion. For anyone.

Admittedly, most hospices have given in to the pressure to go the route of Medicare reimbursement. It is the way of the world and perhaps it is tilting at windmills, clinging to the notion that Martha’s Vineyard can keep doing it the way it was meant to be done. But, isn’t that a decision that belongs to the greater community — not just to the VNA?

Juleann VanBelle, RN CHPN

West Tisbury

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END-OF-LIFE CARE

Editors, Vineyard Gazette:

Most of us washashores come to the Vineyard to be near family, get a good job or simply to enjoy the richness of the Island itself. I came for all those reasons but I stay here because of things not quite so obvious when I first arrived.

It seems there’s always something lurking around the corner here on this little rural Island ready to suck me in. I was first lured by Island Health Care in Edgartown where I worked as a nurse practitioner for four years. It’s a little gem of a place that puts primary health care ahead of profit. The other was the Martha’s Vineyard Cancer Support Group that actually gives away real money to help Islanders cope with cancer. With great regret, I am winding down from these two selfless organizations to pursue what I think is the tastiest bait on the Vineyard, Hospice of Martha’s Vineyard.

When they asked me to join the board, I never looked back. I have hospice in my veins. I knew hospice from both sides, inside and out, first as the clinical director for a hospice in the Boston area and then when my husband was dying from lung cancer. I knew firsthand insatiable grief and despair, pain and comfort, loss and recovery. And I know what it takes to make it work.

When the wheels fall off, when your world seems like it’s coming to an end — not just anyone or anything can get you or your loved one to where you’re going. It takes a team that helps you look ahead to what you fear most. It’s a team that can offer comfort in a terribly uncomfortable situation. This is the oxymoronic challenge of hospice workers, to help people live while they are dying.

Certainly, only those who have experience can work in the hospice setting — dedicated social workers and bereavement counselors who know how to suspend their own expectations, volunteers who do far more than hold hands, and nurses who take a back seat to the needs of patients and their families. Anyone who has been called to this work knows the difference between acute care and end-of-life care. One cannot do both.

I went to my first Hospice of Martha’s Vineyard board meeting last week. I had no idea what to expect. I just knew the reputation of the hospice. It was their annual meeting, so everyone involved in the hospice turned out. It was held in the big conference room at the Congregational Church in West Tisbury, and it was jammed. So many dedicated people in one room. I was overwhelmed.

In addition to the traditional annual meeting agenda, there were letters from families of patients whom the hospice nurses, clergy, social workers and volunteers have served. These letters of gratitude made it all tangible. I felt like I had come full circle.

Whether or not Hospice of Martha’s Vineyard becomes Medicare certified, in my reading of the 2008 budget I saw they are holding expenses down while continuing year after year to serve the needs of their clients. For instance there is a fund called the Christopher Fund that helps patients and families with financial needs pay for medicines, equipment, even fuel oil. The few paid employees offered to forego pay increases this year. There’s more, but to summarize the five-page report, they are clearly fiscally responsible.

So this washashore will stay here, reveling in the sunshine of a new endeavor, meeting new friends with a common goal — to bring comfort to those who need it most, to put the wheels back on and keep the wagon rolling for just a little longer. There’s always something wonderful to discover here on our little Island and Hospice of Martha’s Vineyard is one of them.

Lin DeYoung, MSN, MPH, ACRN

Edgartown

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FAREWELL JUDY OLSON

Editors, Vineyard Gazette:

The staff of the Vineyard Nursing Association, with heavy hearts, says goodbye to a VNA family member, Judy Olson.

For nearly two decades Judy has been an integral part of the VNA team. She has assisted countless patients with her compassion, incredible knowledge, and abundant professional resources.

Judy’s sincere desire to improve the quality of life for all she could included working with the VNA staff. Judy could be found, on any day, in our offices meeting with staff members who requested her counsel for personal reasons or, monthly, conducting Home Health Aide Support Group meetings to help the home care aide staff manage the emotional roller coaster of the work they do every day, or lending her expertise to one of our many committees in her efforts to help us better care for the Island community.

Judy’s passing has surely left a hole in our hearts, and a void in our agency, but also, a legacy of caring and selflessness that we will carry forward as she would want us to do.

Our sympathies go out to her husband, Dick Olson, and all her family and friends.

Bob Tonti

West Tisbury

Mr. Tonti is the CEO of the Vineyard Nursing Association.

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HOW TO VOTE?

Editors, Vineyard Gazette:

The people of Oak Bluffs should know why I asked the board of selectmen to place a nonbinding question on the election ballot in April.

There are two ways to get to vote by ballot on an issue at a town meeting. The first is for people to make and approve a motion to vote on an issue by ballot. It needs a majority to pass.

The second is for the moderator to call for a ballot vote. In that case he acts alone in his discretion.

You should realize that the first way of getting to a ballot vote offers only illusory anonymity. After a voice vote on a motion to vote by ballot, any seven people may stand to question my call of that vote and then I have to take a standing vote. It can be just as awkward and revealing to stand up for a ballot vote as to stand up and vote on the issue itself. Each sends the same signal and anyone can see it.

Although ballot votes can be taken very simply and quickly, I have called for only one such vote in my 10 years in Oak Bluffs. A change in settled voting procedures should be made — if at all — only after a clear signal is given by the people.

Lately I’ve heard more interest in ballot voting in our town than ever before. Many do not like to stand up and vote publicly — under observation — on major, sensitive issues. Some say they don’t attend or vote at town meetings because they don’t like the way we take such votes now. No one needs to know how anyone votes at an open town meeting.

The most anonymous and respectful voting at town meeting would be by ballot called for by the moderator, as I did some years ago on the Southern Woodlands. Given the power to call for ballot voting — which should be exercised rarely and only on substantial, highly-sensitive issues — I should know how people feel about this change. Do they favorite it, oppose it or not care? Why not ask them? And why not see if it would improve attendance?

The selectmen can put the question on the ballot in April. What harm is there in finding out how people really feel about it? A moderator serves the people — why not let the people tell him how to act on their behalf?

It will not cost a single dime to put the question on the ballot. It can be approved by the board of selectmen on March 10 and you can answer it on the ballot on April 16. The result will be a signal to me. That is democracy! Give it a chance!

Lately we’ve had advisory ballot questions on summer ferry service, shark tournaments, and the town building campus. Why not on a change to private and respectful voting on certain issues at town meetings? Important? I think so.

Dave Richardson

Moderator

Oak Bluffs

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FOOD FOR THOUGHT

Editors, Vineyard Gazette:

Thank you so much for the article in your paper on the Island Food Pantry by Mark Alan Lovewell. It was both informative and helpful.

To further inform, I would like to comment on our endowment fund. Despite are taking a hit from the downturn of the economy, it was bolstered by two estate contributions and by proceeds of Lia Kahler’s concert in July: Still the Hunger.

Thank you for your coverage.

Armen Hanjian

Oak Bluffs

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HOME PORT HURRAH

Editors, Vineyard Gazette:

Regarding the Gazette article, Home Port Changes Hands; Owners Hope Loyals Return. Hurray for the Nixons!

Thank you for having the foresight and financial courage for saving one of the Island’s greatest traditions, and a damned good restaurant! You played fair and square and the voters listened to you. I, as many others across the Island, would starve to death in the summer if the infamous take-out had been shut down. Your idea of keeping it exactly the same is nothing less than a brilliant business decision. If it ain’t broke don’t fix it.

Bosuns whistle. Sweepers away!

Dilly, Barbara, Kara,

Marisa and Dylan Walsh

Chilmark

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MOOR MONEY

Editors, Vineyard Gazette:

This is a copy of a letter sent to Todd Alexander, Harbormaster of Oak Bluffs.

The economies of the world, USA, states, and cities and towns, including Oak Bluffs, are in recession. Food stamp applications in Massachusetts, including Oak Bluffs, have increased 200 per cent. State aid to cities and towns, including Oak Bluffs, has been cut. School, fire, police and other employees across the state, including Oak Bluffs, are being laid off and/or having their salaries, over-time and benefits reduced.

Oak Bluffs can no longer afford to provide what amounts to a $30,000 subsidy to the East Chop Beach Club and to the members of the East Chop Yacht Club by permitting them to occupy, as they have done in past years, 20 private harbor moorings in violation of the Town’s Harbor By-Law and Harbor Regulations. The permits to maintain these moorings expired on December 31, 2008. You should notify the Beach Club that the permits will not be renewed, that, as required by the aforementioned By-Law and Regulations, the moorings should be turned over to the Town, and that they will be managed by the Town as seasonal rentals for a fee of $1,500 each. You should request the names and addresses of the 20 members of the Yacht Club who rented these moorings last year from the Beach Club so that you can mail them rental applications for the 2009 season, thereby providing the Town with an additional $30,000 of Harbor income.

Joe Vera

Oak Bluffs

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INN PROTEST

Editors, Vineyard Gazette:

This is a copy of a letter to the Edgartown Zoning Board, regarding the March 4, 2009 meeting, Re: petition from Dudley Canaada.

In stating my feelings and my emotions regarding Mr. Canaada’s petition, if I were to be brief, and am I not always brief when speaking at board meetings, I would say, “NO, emphatically NO.”

My heart sinks, often times, when reading the legal notices for Edgartown when I read of petitions to one town board or another as to a person, or persons, or building firms, who want to change “the face” of Edgartown. I loved the face of Edgartown, and other Island towns, when I was a kid growing up in Edgartown, and chose to return to what I thought would be a like place, if not the same, in my later years when my husband retired...

In 1964 I wrote a letter to the Vineyard Gazette, which Henry Hough chose to run as an article for the Invitation Issue of the Gazette. It was titled, A Lover Of The Island Departs, which I had written on the top deck of the ferry after an August vacation with my family. I wish I could read it to you tonight because unless one lives in the “boonies” of an up-Island location it wouldn’t ring true today.

The former Shiretown Inn, at 44 North Water street, is where Mr. Canaada wishes for permission to, in actuality, do a demolition job on the building. Replace the “stoop” (archaic word), with an open porch, put on a garage, a two-story addition, third floor dormers, a roof deck and a porch with roof terrace. Lordy, Lordy, Lordy. For a single family residence? Prove it.

This is in the Historic District. The Simpson House behind 44 North Water street. went through investigation (the Historic Commission made a visit to the site), and what happened there?

Please, I am only one voice, but please do not approve this petition. Let us, please, keep more than enough history of this town, this Island, so that it doesn’t just become another town in New England. We need to keep more than a little of the old charm..

Eck Wolff

(Ethel Smith Wolff)

Edgartown

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NATIVE LIVES

Editors, Vineyard Gazette:

In response to the letter from Mr. Sequeira. You were asking, “What had happened to natives and their wonderful lifestyle and unique community?” I don’t think your trash and collectibles are what they had in mind. I am not a native to the Island but I like yourself seek out the best places to fish and enjoy what the Island offers. Funny but none of those places have multiple junk cars, old boats that will never see the ocean again, and just plain old trash. In your letter you said, “We had pigs, we had chickens, we had gardens.” You also go on to say, “You were a fisherman and you were a scalloper.” Sounds to me like it’s time to let go of the past and get rid of the rusty broken-down reminders. I noticed in the letter you needed several junk cars to keep the one family car running. Can you tell me how the old Ford keeps the old Buick running? One last thing: You talk about the environmental hazards and water supply contamination. Would you be willing to have your soil tested? Maybe we start with the spot under the leaky tractor or those several cars, even better under your fleet of fishing vessels. One thing you’re forgetting; those developments are your bread and butter. Most working class Islanders that I have met have respect for others and take pride in what they have. Nobody’s listening to your violin solo. Just clean it up!

Scott Corey

Edgartown

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COME CLEAN IN DOCU-SOAP

Editors, Vineyard Gazette:

“The friends you choose, the parties you attend, and the decisions you make will define who you are. Summertime At Martha’s Vineyard...” — from vineyardcasting.com, Web site ad seeking applicants to their TV docu-soap.

I don’t understand all the talk and all the worry over the real Vineyard not being portrayed fairly on this proposed TV show. What is the real Vineyard? And why do so many people think this show is okay as long as it brings in money to our local economy? Isn’t that what went wrong and why we lost the old Vineyard?

I think the advertised come-on for this show sounds amazingly like what happens on the porch at the Chilmark Store in the middle of July and August. This brand of “essence” of Vineyard life is as real and essential for these ninnies, all vying for the same party invites and seeing who can be the most “laid-back” about it, as is the reality of life here for those with polar opposite concerns —like the struggle to afford living here.

Locals, if you’re good-looking and young, this is an opportunity to get on TV to disprove that much of life here is spoiled indulgence, shallow, nasty, competitive and unfair. You can also showcase that you, the good-looking, young locals (and your parents), haven’t sold your souls to the highest, mansion-building bidder and that you are way far above this nonsense because you are real, honest-to-goodness, year-round, native-born Islanders.

The Vineyard is a lot of things to a lot of people. Everyone knows this is a place of incredible physical beauty, and for many it can be a great place to spend time or live. There are some extraordinary people quietly working away and living out their lives here. But living on the Island full-time is a challenge for many who are the less glamourous, less youthful, and less popular than some of those being courted for this new docu-soap. That’s where the producers of this show hope the fun begins. The producers think it will be enlightening to see how the different “cliques” — consisting of native-born, visiting or washashore working stiffs, and the vacationing over-privileged — sort out who is more... more real? more likable? Maybe the idea is just to see how people get along and sort out who is more alpha, in an Animal Farm sort of way.

The reality is, year round and summer, the real Vineyard is just like every other place in the world, made good and bad by the people who inhabit the place. Most people, locals and visitors alike, who go on and on about how great the Vineyard is, what a special place it is, how welcoming, supportive and nurturing, are not seeing the whole picture, the reality from other perspectives, and how very hard life is here for a growing number of people.

I hope there will be native-born locals who apply to be on this docu-soap. I hope they make it through and we all get to see that they are just like everyone else who goes on these shows: human. Let the reality of the Vineyard in all its different guises — privileged, shallow pretentiousness to heart-breaking and hungry — be shown. TV show or not, it’s not like people haven’t noticed that most Islanders sold out a long time ago.

Jacqueline Mendez-Diez

Chilmark

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CHILMARK CITIZENSHIP

Editors, Vineyard Gazette:

This is a copy of a letter I sent to the Chilmark selectmen:

This letter is in response to an article in the paper regarding your discussions about the long-term uses of “affordable housing”. I hope you will think about it while you review the proposed restrictions before you this week.

The young people who grew up here and want to live in Chilmark need homes; if they cannot find homes here eventually they will go elsewhere, which may or may not be good for the young but it will surely be bad for Chilmark.

We have tried several different ways to use housing incentives to achieve a better community. By far the most effective has been the earliest and simplest, the youth lot. If our goal is to maintain a community, then we need to be very clear about what that means to us as a town. Maintaining the poverty level of the occupants of a particular house is not my goal, nor should it be yours. Nurturing our community is a difficult and complex job but it can be done. As they were originally conceived, one of the ways youth lots could be used was as a sort of scholarship awarded to a few of our local kids to help them achieve full citizenship in their community. It worked. Many of our most valued citizens have benefited from those scholarships. We did not ask them to stay poor forever or to keep their children poor. Just the opposite. We hoped they would prosper and most of them have, but let us be very clear, no one has gotten rich off a youth lot.

When we talk of permanent restrictions on affordable lots we are talking about maintaining a part of our community in second-class citizenship forever. Why would we want to do that? I have heard the arguments about running out of affordable housing and how we need to keep all affordable housing in the pool forever. Such discussions make sense when we are talking about community-owned rental housing but if we want to keep at least a few of the best and the brightest of our children in their community they need to be able to see their way toward equal citizenship.

The Selectmen as a board have an opportunity to either help build a better community, by giving the scholarship assistance that will make the difference and help a few of our young people to achieve full citizenship; or, as a board, you can use your influence to make it so onerous to live here that all the best and the brightest will move off in search of a real community. That would be a great loss for Chilmark.

Chris Murphy

Chilmark

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WONDERFUL WINDEMERE

Editors, Vineyard Gazette:

I wish to extend my gratitude to the wonderful staff at Windermere for the excellent care they gave my husband the past three years and for providing a warm happy home for him. I could not have asked for a more loving, caring atmosphere.

I also wish to extend thanks to hospice for quietly providing support and loving care as well.

We are blessed to have these excellent facilities on Martha’s Vineyard.

Sally Nicholas

Edgartown

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NEW MUSIC HALL OF FAME

Editors, Vineyard Gazette:

I tend to a Windemere resident on a regular basis. One of the many activities she enjoys is the recreation deptartment’s music program. I, too, laud this program and all the musicians of talent and good heart. It is truly lifting to see the effect of music on each person there — the foot-tapping, harmony singing, dancing in the aisle, the smiles and applause, the repartee. I commend (along with other Island musicians) Dorothy Bangs, Phil Diettrich, Mark Lovewell, Rick and Franklin O’Gorman, Arthur Silvia, and Taffy McCarthy with Bob Johnston and Edson Rodgers, to what should be a musical hallway of fame and compassion.

Meg Spokus

Edgartown

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THINK AGAIN MSPCA

Editors, Vineyard Gazette:

This is a copy of a letter sent to the directors of MSPCA;

I was astounded and very saddened to read of the planned closing of the Martha’s Vineyard shelter. I am not a resident of Martha’s Vineyard but do vacation there. I have donated items to the shelter and found it to be a caring, clean facility. Residents and abandoned animals on Martha’s Vineyard cannot easily go to another facility. An Island shelter is more isolated than one in a neighboring community! The necessary ferry ride serves as a huge impediment and abandoned animals are going to be left to fend on their own.

I have always contributed to MSPCA, believing in its honorable and respected mission to protect animals, left without caring humans. Now all of this belief is thrown into question. I read the newspapers, listen to the news, hear the questioning of large salaries. Am I just naive; should cynicism reign?

I urge you to reconsider the closing of the Martha’s Vineyard facility. The abandoned animals on the Island really need you!

Pat Lewis

Edgartown