For families dealing with a terminally ill loved one, the end of life can be a confusing and overwhelming time for patients and caretakers alike. To ease this burden and give families more options, Hospice By The Bay has established a room at Sonoma Valley Hospital where patients can get the care they need in their final days.
“This is the most trying time for any person,” said Sandra Lew, chief executive officer of Hospice By The Bay. “Sometimes families just can’t deal with all of the stress of having a loved one die at home. To say, ‘I’m going to bring you to a lovely place,’ that really helps relieve the guilt they might feel.”
Located in the hospital’s skilled nursing facility, the room was remodeled with funds raised by Hospice By The Bay to create a space that seems more like a bedroom than a hospital room. With soft colors, decorative art, fresh flowers and a quilt hand-made for each patient, the goal was to feel less clinical and provide the comforts of home, while remaining within arms reach of the medical staff at the hospital.
“It was a room that we really wanted to stand out from any other hospital room. We really wanted it to look homey and nice, not sterile like many hospital rooms,” Lew said, explaining that there’s room for family members to spend the night as well. “It doesn’t have the same rigidity as normal hospital rooms where there are visiting hours, people can come whenever they want.”
While the hospital has long worked in concert with hospice, the two nonprofit entities launched their first official partnership, a palliative care program, around three years ago. Aimed at chronically ill patients, the two share the cost of staffing nurse practitioner Geoffrey Van Den Brande, who helps families make a plan for long-term care, which sometimes includes a Physician Orders for Life-Sustaining Treatment (POLST) directive.
“Palliative care is an effort to improve quality of life and help patients make health care decisions,” said Dr. Robert Cohen, chief medical officer at Sonoma Valley Hospital, who helped launch the program. “So now, those plans aren’t made with me in crisis in the emergency room. In a state of calm, we can make those decisions before a crisis occurs.”
Lew said Hospice By The Bay, the second oldest hospice in the country, has long fielded inquires about in-patient care for clients who do not have family support or who simply prefer not to die at home. The cost of building and staffing such a facility was too high for the nonprofit to manage, so it looked for alternative options.
“We first partnered with (SVH) on this palliative care program. A natural segue was this concept of having a bed in the hospital for these patients who could not be managed at home,” Lew said, explaining that the hospital immediately agreed to the idea.
“It was so remarkable, they were interested from day one. We work with a lot of hospitals and it’s rare you find this kind of can-do attitude,” Lew said. “It’s a credit to the administration at the hospital for being so open-minded and putting the community first.”
Since Medicare doesn’t cover this type of patient-directed end-of-life care in a hospital setting, there would likely be a cost associated with treating patients, Lew said. Because patients in the hospice room receive care from the hospital and hospice during their stay, both entities will contribute to the expense of caring for hospice patients.
“Basic medical care is provided by hospice, but (hospital staff) is always here to help,” Cohen said. “This is not a money-making operation for the hospital, if we break even, we’ll be happy.”
While other medical facilities in the nation have partnered with hospices on similar models, Sonoma Valley Hospital is the only hospital in the Bay Area that offers a hospice room, Lew said. In the few months since it opened, it has been well-utilized by hospice clients.
“Most days, it has been occupied,” said Melissa Evans, director of the skilled nursing facility at the hospital. “It’s been a blessing to the families because our nurses provide 24-hour care for their loved one. It gives the family a reprieve. We can also manage pain really well in the hospital, so patients are very comfortable.”
Hospice By The Bay works with families to decide the right time to transition from care at home to treatment at the hospital. “We recommend this option for any patient who cannot die at home,” Lew said, adding that hospice will continue to fundraise to keep this room open to hospice patients. “It’s only through charitable donations that this option is available.”
She said the seed money for this project was raised at the hospice’s gala fundraiser last November, with additional contributions from Sonoma’s Impact100, which helped cover the expense of remodeling the room. But there will be continued costs to care for hospice clients at Sonoma Valley Hospital, which will require additional donations.
“Medical care is so costly, period. Our assumption is that most people won’t be able to pay for their time in this room,” Lew said. “We will continue to raise funds for this program.”
To learn more about Hospice By The Bay or to contribute, visit hospicebythebay.org or call