"Everyone seems to have a story about going through a situation with family members [in which] we wish we'd have considered hospice, not taken the route we did," he says.

Johnson has such a story. A terminally ill brother decided to spend his last days among family members, but they were unfamiliar with hospice and left him in traditional medical care.

When he needed medical attention, loved ones had to call 911. Ambulance drivers would rush him to any of a number of hospitals, "often with tubes sticking out of his arms," Johnson says, making his final weeks on earth chaotic and stressful.

He heard many similar stories, each with a unique twist. There were seniors the health department could not follow frequently enough; some fell out of touch for two or three days only to be discovered deceased. Others chose to stay with family as they fell ill only to find relatives too busy to do such simple things as turning the individual over in bed.

Those who did know about hospice, he says, didn't trust it. Many believed it was a form of secret euthanasia. Others saw using the service as giving up on a loved one. Some said staffers weren't well-trained or diverse enough.

Karen Cousins-Brown, an African-American geriatrician who works as medical director of Joseph Richey Hospice in Baltimore, cites the persistence of what she calls "the Tuskegee Experiment Syndrome." That's her term for a suspicion among many blacks, especially those over 65, that the health care system will give them second-class treatment — or make them the unwitting subjects of medical experiments.

The U.S. Public Health Service did exactly that with scores of black men during the infamous Tuskegee syphilis study between 1932 and 1972.

Shortly afterward, the federal government adopted stringent laws dictating that patients involved in any form of experimentation be fully informed on the goals and methods, but the project's notoriety lingers.

"Many people said, 'I'm not going to let them experiment on me,'" Johnson says. "We want to bring our folks up to date that a lot of [those fears] are not based in actual fact."

The goal of the Morgan State conference, organizers said, was to counter such misinformation.

Posted signs in a ballroom venue listed "myths" (for instance, that it's doctors who decide when patients enter hospice), replacing them with "truths" (it's patients and their families who make that call). Ministers quoted Ecclesiastes ("There's a time to be born and a time to die") and other scripture. And anecdotes abounded.

Cousins-Brown, a keynote speaker, told of her mother, a woman in her 80s who for years refused even to speak about death. But when some of her friends began to pass away, she began to imagine what her own funeral should be like, Cousins-Brown said.

Apparently she disapproved of some of her late friends' interment attire.

"You're not burying me in something like that," she said, according to her daughter.

The tale got laughs but also made a larger point: In a day and age when people are living longer yet dying in less comfortable ways than ever, it takes planning to assure a pleasant end of life.

"If you hear nothing else I say today, I hope you hear this," Mary Weeks, a hospice nurse with the Veterans Administration, said in a stirring speech. "Ask yourself, 'What does quality of life mean for me?' Take steps to be sure it happens."

One health official, Arnold Eppel, the director of the city's Office of Aging and Care Services, says that should mean, at least, that every adult make decisions on "the five wishes" — five questions a prominent advocacy group, Aging With Dignity, has said everyone should be clear on well in advance.

Those include what kind of medical intervention people want and don't want as they enter their senior years and who should make care decisions if they become unable.

Eppel's office will distribute place mats bearing the wishes in senior centers next year. He and his colleagues plan to visit each house of worship that has expressed interest in hospice (more than 60 have left contact information).

Johnson has plans to start taking faith leaders on tours of hospice sites next month.

"We're just getting started with this," he says.

Kane, meanwhile, says hospice care has in many ways saved her life. She especially enjoys one service Gilchrist offers: On a regular basis, staffers pick her mother up and transport her to their Towson inpatient facility for a five-day stay.

It isn't just that Kane gets a much-needed break; her mother loves the visits. Last spring, a staffer even rolled the bedridden Franklin onto the grounds and into a private garden, where she spent the afternoon soaking up sunlight, watching butterflies and even listening as a vocal group sang hymns, all without having to get up.

"Hospice has been wonderful for us," Kane says. "And that day was like heaven on this earth."

jonathan.pitts@baltsun.com