By Kathleen O'Neil
City of Hope patients can now choose to receive hospice care while remaining on campus, allowing them to closely stay in touch with their physicians. Four apartments within Hope Village and Parsons Village have been converted into hospice units where patients who are in the terminal stages of life can receive specialized care.
Patients can choose to stay at City of Hope and receive care from Hospice of Pasadena/Presbyterian Intercommunity Hospital’s hospice nurses and physicians, along with City of Hope staff.
The four “Village Hospice” units have been newly refurbished with funding provided through a grant from The Home Depot. Each includes spacious living quarters for the patient and a family member, with a full kitchen, sleeping/living room and fully handicap-accessible bathroom.
“This new endeavor will allow a full continuum of care to our patients, with availability of hospice units in a beautiful, park-like setting. It will also provide access to additional bed space within City of Hope Helford Clinical Research Hospital, to meet our growing patient needs,” said Alexandra Levine, M.D., chief medical officer.
Michael Rabin, vice president of managed care, said the new agreement gives patients another option if they do not want to go home. “The goal is to make people comfortable at the end of life, and most people don’t want to die in a hospital setting,” he said.
Hospice care is a valuable option for patients who can gain no further benefit from continuing curative treatment or who decide they no longer want to receive it. Hospice provides comfort care to relieve symptoms and prepares patients and their families for death while preserving the patient’s dignity. It also offers patients more choices and control over their surroundings than they would have inside a hospital.
Having a good death can take some planning. Anne Tanner, R.N., M.N., director of case management, said discussing end-of-life issues may be difficult, but it is a conversation that patients, doctors and family members shoud have early on. “Shortly after the patient comes to terms with a catastrophic diagnosis, the doctor should ask, ‘Should the treatment not work, what are your wishes? If you want to have a quality end of life, how is that defined for you?’ Planning for an ideal end of life is just as important as planning for any other major life event,” she said.
Patients also have the option of going home to receive hospice care, with care provided by hospicetrained visiting nurses and staff. For those who need or prefer to be in an inpatient facility, City of Hope also provides referrals to inpatient facilities. Some of these facilities are located in residential areas, such as one run by the Hospice Homes of Presbyterian in Whittier. The homes look and feel like well-maintained residences. They are open to family members at any time, and even pets are welcome to visit.
Medicare allows hospices to accept patients when they are expected to live no more than six months. However, determining how much time a patient will live can be very difficult, and is one of the reasons that many patients do not receive hospice care soon enough. With planning and coordination from a patient’s physician, that time with hospice can be implemented earlier, giving patients and their families more time to plan and prepare themselves.
“There are a lot of things to prepare for when you’re dying: to have closure to hurt feelings, say goodbye, put your affairs in order, and to be able to die in peace with dignity and hope,” said Jan Bounds, R.N., of the nonprofit Hospice Homes of Presbyterian.
Shirley Otis-Green, M.S.W., L.C.S.W., senior research specialist in City of Hope’s Department of Nursing Research & Education, said surveys support that perception. “Patients who have the support of a really qualified, well-rounded team like hospice offers usually report the most positive outcomes,” she noted. “Most people say ‘I wish I’d done it sooner.’”