Residential hospices - open door policies?

[HealthShepherd]

Hello all. This is a question for anyone with experience in residential hospice.

My mother has a big 6-bedroom house that was built by my late father. She is considering donating the house to a group in her town that is hoping to establish a hospice with day programs and with bedrooms for 24/7 care.

If she donates the house, she would like to have some kind of name for the hospice (or perhaps the rooms) that is a tribute to my father, which seems reasonable to me.

However, she is also thinking of stipulating that there be some sort of memorial spot in the house where his ashes and war medals would reside. Again, I think that having this memorial somewhere would be fine, but that it would not be fine for her (or other family members) to expect to be able to visit the memorial like you would visit a grave.

My mom is thinking that it would be like a hospital where anyone can stroll in, look at the pictures on the walls, or go to the cafeteria or gift shop, and nobody asks whether they have legitimate reason to be in the hospital. I've never been in a residential hospice, but my guess is that they wouldn't be open to the public stopping by, in the interests of making a home-like atmosphere and protecting the patients' privacy and security.

On the other hand, even if visiting was generally restricted to the dying person's close friends and family, maybe they'd make an exception for a major benefactress.

What do you think? Would she still have access to the house occasionally, if she donated it?

Thanks, Rhymeswithlibrarian

[KtHospiceRNCM]

I have never heard of a "residential hospice".. I take it you mean that the house would function as a facility, like an In-Patient hospice unit.. I don't see how that is possible. Hospice services can be provided in a patient's home of course, but to have this house be the actual hospice unit/facility doesn't seem realistic.

If anyone has any information on this please share!

[lifelearningrn, BSN, RN]

I don't think converting the home into a hospice is unrealistic.. but allowing people to stop in and browse and visit the memorial does. If it were a bed & breakfast, maybe.. but not a place where people are going for their last days or hours. JMHO.

[oramar]

At a Mt. Lebanon hospice, a carefully designed garden and therapy dog bring solace to patients

[heron, ASN, RN]

I'm assuming that a "residential hospice" would care for people who are too disabled for families to care for at home yet are not unstable enough to qualify for inpatient "GIP" status, which has fairly strict criteria.

I agree that the donation does not warrant allowing someone who is essentially a stranger to walk around at will through the house. Once the house is donated, it no longer belongs to your mom and she has to abide by the same privacy constraints as the general public.

I think that the idea of putting the memorial in a public reception area (if there is one) or in a sheltered outdoor garden is a good one, and would meet your mom's need to visit the memorial without intruding on residents.

[HealthShepherd]

Thanks for your responses, everybody.

As I understand it, the population being served would be people whose families aren't equipped to care for them at home, and who want to die somewhere more quiet and intimate than a hospital or nursing home. So they would move in when death was expected in a few months or less, and stay there until death. There would be 24 hour nursing and/or PSW care.

The garden memorial idea may be a good compromise; I'll pass that suggestion on.

[ZippyGBR, BSN, RN]

I have never heard of a "residential hospice".. I take it you mean that the house would function as a facility, like an In-Patient hospice unit.. I don't see how that is possible. Hospice services can be provided in a patient's home of course, but to have this house be the actual hospice unit/facility doesn't seem realistic.

If anyone has any information on this please share!

the original Hospice model is based around small, 'homely' inpatient units ... depending on layout there are issues, but there is no reason why a large house could not form the core of an inpatient hospice unit especially if there is sufficient space to expand to provide ground floor bedrooms and/ or a stretcher sized lift to the first floor ...

most Uk hospices are small (in relative terms i.e. tens of beds rather than hundreds in acute hospitals) separate from an acute hospital units - some are based around large old houses, extended and modified and others are entirely purpose built ...

[KtHospiceRNCM]

IMO, Hospice should be viewed as a level of care.. not just a place to go die. Although that is sometimes a portion of Hospice care, as a whole Hospice is comfort care. Also, there are patients that stay on Hospice for more than the 6 months or less most associate with Hospice, I've had patients for 2 years.. all depends on the Dx and progression of disease. Hospice units themselves generally do not keep patients there for extended periods of time (to my knowledge), Medicare does not pay for inpatient care just because the family can not/will not care for the patient, although respite and caregiver distress cases do warrant inpatient levels of care, or 24 hour bedside care if a Hospice provides that. But not for months at a time, weeks at a time is even a stretch depending on the case.

I hope to learn more about Hospice than I know just from working with one as a CNA. I plan to become a Hospice RN, promoting the best quality of life possible for everyone.

I love the idea of a residential hospice you all have described! Innovation in healthcare is the key!!

[evolvingrn, BSN, RN]

our residential side of our hospice is attached to our acute inpatient unit. People can visit... I guess it depend on the atmosphere. All hospice facilities have to have volunteers its a medicaid stipulation i believe. Perhaps she could be a volunteer and be part of a fantastic movement and get to visit her husbands memorial.

[HealthShepherd]

Thanks for your further responses.

We're in Canada, so the care would be covered by provincial health insurance. It's up to the committee to find funds to buy and renovate a building, though.