When Chestertown’s Becky DeMattia, Talbot Hospice’s bereavement coordinator, talks about providing support for children who grieve, it might seem odd at first to hear her talk about interjecting fun as part of that effort. But as you begin to understand that kids work through bereavement very differently from adults,  it becomes much more clear how important a camp environment might be for a child struggling with the loss of a parent or another loved one.

As Becky tells us in our Spy interview, this is the reason that Talbot Hospice has just started Talbot Kids Grief Camp. This special children’s bereavement camp is designed for any youth, ages 6-12, who have experienced that kind of loss. This two-day camp will be held May 18-19, 2019, at the Talbot County Agricultural Center, and there is space for 35 participants. Each child attends the camp at no cost, to learn how to cope with the complex feelings of grief.

The goal is to provide an opportunity for children to process their losses in a healthy, peer supported environment via a curriculum of activities and therapeutic practices designed to teach children about themselves, and the grief they are experiencing. Together campers will discover ways to cope, realize they are a valuable member of the group and work together to overcome challenges ahead. The camp will also provide grief education, support, and resources to parents and families and help strengthen the family unit as they process the loss together.

We spent some time with Becky at the Hospice office in Easton last week.

For more information about Talbot Kids Grief Camp please contact Becky DeMattia at 410-822-6681 or bdemattia@talbothospice.org.

The Maryland House on Thursday passed a measure that would give terminally ill patients six months from death the option to end their lives by taking prescribed lethal medication.

House bill 399, or the End-of-Life Option Act, received 74 votes for and 66 against in an impassioned chamber session.

Individuals are required to consent three times to death. “Lethal injection, mercy killing or euthanasia,” would not be legal under the legislation, according to the bill’s analysis. There would be criminal penalties for people who coerce others into ending their lives.
The debate began with some tension, but soon cooled off, as personal anecdotes of experiences with death or near-death brought tears to the eyes of members of the chamber.

Democratic and Republican delegates opposed the bill, saying they had religious and moral objections, and detailing how important each day alive was to many of their relatives who died from terminal illnesses.

“Because I am a believer,” God should be answered to, not nurses or doctors, Delegate Jay Walker, D-Prince George’s, said. “Give my Lord the opportunity of a miracle.”

“Doctors take an oath, the Hippocratic oath, to do no harm,” Delegate Haven Shoemaker, R-Carroll, told Capital News Service.

“We’re encouraging (physicians) to contravene that oath,” Shoemaker said.

“Think about vulnerable populations” who could be taken advantage of by this legislation, said House Minority Leader Nicholaus Kipke, R-Anne Arundel. “Less than 5 percent of the poor receive hospice care at the end of life.”

If many people begin ending their lives prematurely, “we wouldn’t look for a cure,” to their diseases, said Minority Whip Kathy Szeliga, R-Baltimore and Harford counties.

Delegate Cheryl Glenn, D-Baltimore, spoke of her sister who died of a terminal illness.

She would not have made peace with her only son if she had ended her life early, Glenn said. “We don’t know what tomorrow will hold.”

Democratic supporters argued that individuals deserve the right and option to choose when they die.

Delegate Shane Pendergrass, D-Howard, lead sponsor of the legislation, told the stories of two people who fought breast and brain cancer.

Knowing the medication to end your life is there gives comfort and control to an individual who is suffering, Pendergrass said.

Delegate Eric Luedtke, D-Montgomery, said he had three family members attempt suicide, and spoke of his mother who tried to end her life from the pain of her cancer.

“Despite my personal hatred for suicide, I began to ask myself what right I had as a government official, and even as her son, to dictate to her how her life should end,” Luedtke said.

Individuals can already choose to not be resuscitated and be taken off a feeding tube, Delegate Elizabeth Proctor, D-Charles and Prince George’s, said. The bill just gives people at the end of life another option, Proctor said.

Delegate Sandy Bartlett, D-Anne Arundel, told her story of anguish following mastectomies for breast cancer.

Deciding to end one’s life is up to “her, and her choice only,” Bartlett said, speaking of herself.

The bill “does not impose beliefs on anyone,” said Delegate Terri Hill, D-Baltimore and Howard counties, a physician. “I expect that the positions we’ve taken have been thoughtful and spiritually guided.”

The chamber was silent following the final vote.

Now that the legislation has passed the House, an identical bill must pass the Senate, and then must not be vetoed by Gov. Larry Hogan, R, to become law.

“I’m going to give a lot of heartful and thoughtful consideration,” to the act, Hogan said in February.

California, Colorado, Hawaii, Oregon, Vermont and Washington, as well as the District of Columbia, have legalized physician-assisted suicide, and Montana has no law prohibiting it.

Seventy-two percent of Americans would support ending a terminally ill patient’s life, according to a 2018 Gallup poll.

The legislation, originally titled the “Richard E. Israel and Roger ‘Pip” Moyer Death with Dignity Act,” was first presented to the General Assembly in 2015.

Israel and Moyer were former members of Annapolis government, and both died in 2015 from Parkinson’s disease.

Pendergrass said after years of supporting the bill, it is “just a remarkable moment” to see the vote of passage for this legislation.

She attributed the bills’ success to testimony she heard and has repeated many times: “Everyone is one bad death away from supporting this bill.”

By David Jahng

UM Shore Regional Health’s 2018 Community Health Improvement Report has been published online and is available for viewing at https://www.umms.org/shore/news/2018/um-shore-regional-healths-2018-community-health-improvement-2018.

UM Shore Regional Health’s most recent Community Health Needs Assessment (CHNA), conducted in 2016, identified top health concerns in the region: chronic disease management (obesity, hypertension, diabetes, tobacco use), behavioral health, access to care, cancer, outreach and education (preventive care, screenings, health literacy).These are the same top health concerns and health barriers indicated by the overall Maryland Department of Health and Mental Hygiene State Health Improvement Process (DHMH SHIP) county data.

UM SRH determined that the greatest transformation in population health in the five-county region would be achieved by focusing on chronic disease management, behavioral health and cancer screenings. An implementation plan was developed for each priority, with key activities to improve care coordination and health education in community settings.

As detailed in the new report, the total value of UM Shore Regional Health’s community health improvement initiatives during 2018 exceeds $40 million. According to Ken Kozel, UM SRH president and CEO, and Kathleen McGrath, regional director, Outreach and Community Health, the document “reflects UM Shore Regional Health’s commitment to building community partnerships that help foster better health outside the walls of our hospitals and outpatient facilities, while enhancing access to care and the overall quality of life in the five counties we serve.”

As part of the University of Maryland Medical System (UMMS), University of Maryland Shore Regional Health is the principal provider of comprehensive health care services for more than 170,000 residents of Caroline, Dorchester, Kent, Queen Anne’s, and Talbot counties on Maryland’s Eastern Shore. UM Shore Regional Health’s team of more than 2,500 employees, medical staff, board members, and volunteers works with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

More than a year after a controversial end-of-life law went into effect in the District of Columbia, advocacy groups say they are now seeing a higher public response to its efforts to ensure city residents know the law exists.

How many people have used the law will become clearer in an upcoming February report. As of last April, no patient had yet used the law, according news accounts.

The Death with Dignity Act allows mentally capable, terminally ill adults with six months to live to request lethal doses of prescription medication so they can die peacefully and comfortably in their homes or any place where they have been granted permission to do so.

One of the law’s main proponents, Compassion & Choices, has helped the District of Columbia Council advocate for the legislation and educate Washington residents about the new option for patients with terminal illnesses.

The administrative side of the end-of-life process apparently has dissuaded physicians, pharmacists and patients from using the law, but local public service announcements have helped spike interest and attention, Sean Crowley, spokesman for Compassion & Choices, told Capital News Service in an interview.

His group declined to say how many doctors in the District registered to use the law, as it did not have access to such records. But as of last April, only two doctors among the roughly 11,000 doctors in the city had registered to use the law and just one hospital had approved doctors for the practice, according to The Washington Post.

The District of Columbia Department of Health is set to release a detailed report in February on how many patients have utilized lethal drugs and how many physicians have administered them. But to date, no patients have volunteered to go public with their stories.

During September, Compassion & Choices distributed television public service announcements promoting the end-of-life law, featuring prominent Washingtonians Diane Rehm, a former WAMU radio show host, and Dr. Omega Silva, a retired physician.

The announcements, which began Labor Day weekend, aired on various Comcast stations. Compassion & Choices reported that there were 229 visits to the group’s page during September, compared to only 56 for the same month a year ago – a 400 percent increase.

In addition to the District, six states have end-of-life, or physician-assisted dying laws: California, Colorado, Hawaii, Oregon, Vermont and Washington, according to the nonprofit Death with Dignity National Center, based in Portland, Oregon.

Efforts to pass a similar law in Maryland have been unsuccessful.

Since the District’s end-of-life bill was introduced in 2015, organizations such as Right to Life and conservatives in Congress have opposed it and tried to defund it.

Rep. Andy Harris, R-Cockeysville, introduced an amendment in 2017 to defund and repeal the law. The amendment failed to pass the House Appropriations Committee.

Harris, a physician, criticized what he called “the so-called Death With Dignity Act,” saying “most people don’t associate suicide with dignity in any way shape or form.”

“It sends a strong message that regardless of the many types of disease you might have and the many types of treatment that may be available, there is one common pathway that in this case the District would say is perfectly acceptable, it is legal,” he said. “It’s actually to go to a physician and ask if they can participate in your suicide. That doesn’t lead to more choice – that leads to one choice.”

The House will be controlled by the Democrats next month, making the prospects for repealing the District bill more remote.

In any case, Crowley said that “lawmakers from outside the District should not dictate to district lawmakers what laws they should pass for their local constituents.”

“Other states would never allow lawmakers from outside their state dictate what their states can do,” he said. “Why should they be allowed to dictate in D.C.?”

Since its founding as the seat of the federal government, the District of Columbia has not had voting representation in Congress, although it has some limited autonomy. Even so, Congress has the power to review and repeal District laws.

“That Congress thinks it should substitute its judgment for the judgment of the residents of the District of Columbia is odious enough,” said Councilmember Mary Cheh, who sponsored the end-of-life bill. “That it would presume to substitute its judgment for the judgment of people who are dying is unconscionable. Such an action is fundamentally undemocratic and it should not stand.”

By Morgan Caplan

As we complete a week dedicated to the awareness of suicide, it is important to review this manifestation of mental illness and what the community and we, family, friends and mental health professionals, can do to address this crisis.

Statistically, it is staggering that suicide is the 3rd Leading cause of death in 15 to 24 year-olds and the 6th leading cause of death in 5 to 14 year-olds according to data from the American Academy of Child and Adolescent Psychiatry (AACAP, Facts for Families, 2013). Center for Disease Control data from 2005 indicated that among 15 – 24 year-olds, suicide accounts for 12.9% of all deaths annually.

This is particularly a concern for high school students who, in a study by Eaton et al in 2006, indicated at 16.9% of all high school students seriously considered suicide in the previous twelve months before the study. Additionally, there are significant cultural differences. The same study documented that Hispanic female high school students reported a higher percentage of suicide attempts than their non-Hispanic peers.

These statistics, however overwhelming, are only overshadowed by the unrelenting pain suicide inflicts on surviving family and friends. Some professionals contend that suicide cannot be prevented but mitigated by focusing on providing alternative choices to desperate situations. That providing those in emotional distress with more appropriate choices to manage their feelings and instead of self harm, utilize different coping skills when overwhelmed.

To that end, open discussion about suicidal behavior and feelings as well as providing alternatives to self harm, are the goal of therapy and community support.
Providing tools to children and their families including crisis lines, access to mental health services and other professional support is key.

Recognition of potential risk factors that indicate emotional distress and could lead to suicidal thoughts or behavior is everyone’s responsibility.
Potential risk factors, described by AACAP (2004), include:

Prior suicide attempts
Substance Abuse
Change in sleeping/eating habits
Withdrawal from family and friends
Unusual neglect of personal appearance
Violent, rebellious behavior
Loss of interest in pleasurable activities
More severe psychiatric symptoms (psychosis)
Complain of feeling “bad” or “rotten” inside
Put his or her “affairs in order”
Verbalize suicidal thoughts or feelings

Underlying mental illness, lack of family and social support as well as limited coping skills also play a pivotal role in suicidal behavior.

How can we, as family, friends and community, help?
Some basic interventions include:
Take threats seriously; notify police or mental health professionals
Be suspicious when there are serious psychiatric symptoms or substance abuse issues
Keep lines of communication open
Seek professional support

Eastern Shore Psychological Services (ESPS) has therapists in all the Talbot County schools working hand in hand with the school guidance counselors ready to help.
ESPS offers mental health, substance abuse and wellness services for all ages. For those seeking mental health services, ESPS offers “same day access” appointments Monday – Thursday at 8 AM at their office at 29520 Canvasback Drive.  For more information, please contact the Clinic at 410-822-5007.

Laurence Pezor, MD is the Chief Medical Officer at Child and Adolescent Psychiatrist with Eastern Shore Psychological Services.