“I’ve only got three priorities,” says Gord Neal, the CEO of Hospice Halifax one month into the job. “Find the money for a Hospice. Build it. Open it.”
The first residential hospice in the province is scheduled to open this October — after 17 years of volunteers dreaming, planning, and fundraising (with the largest push still to come).
Lindsay Construction has poured the foundation for a new, airy, purpose-built residence located on the grounds of the Atlantic School of Theology. People living out their final days can have their bed wheeled out on a deck to enjoy a spectacular view of the Northwest Arm or a peaceful side garden. The house will have 10 rooms for residents, who stay at no charge, will typically live at hospice three months before their death. In general, eligible people can come to hospice one to 12 weeks before their death. One of those rooms will be on display as part of the Home Show this spring but here’s a sneak preview via a Hospice Halifax YouTube vid:
Pets and children will be welcome to visit and there will be round- the -clock nursing care for residents, as well as “anticipatory grief counselling” for family members offered by specially-trained volunteers. Massage and music therapy round out the picture. If it all sounds more like a stay in a hotel than a hospital, that’s part of the idea.
Neal, a hard-driving entrepreneur, came out of retirement at the end of last year during a change of personnel at both the management and board level. Paul Bent, retired from Grant Thornton, took over from Dr. Jane Henderson as Chair.
In 2012, Neal was part of a Dartmouth group called “Entrepreneurs Making A Difference” when Gregg Curwin (founder of Oh My Sole and TruLeaf) suggested they start a hospice. In fact, the seeds had already been sown 11 years earlier by a community group led by Fred McGinn; HRM deeded McGinn’s hospice society a heritage home in Bedford for $1. But the proposed hospice, Pryor House, had a sweeping staircase and required too many renovations to work. The community group eventually handed the building back to the City and received $156,000 for its upgrades. That seed capital eventually blossomed into the modern hospice taking shape in the South End of Halifax.
Ironically, Gord Neal no sooner began to investigate what it would take to build such a place when his research “suddenly turned personal.” His mother in Rothesay, New Brunswick was diagnosed with pancreatic cancer. When her care became too much for the family, she moved to Bobby’s Place, a 10-bed hospice in Saint John that was the first in Atlantic Canada seven years ago. Now when Neal gets asked “what’s a hospice?” he answers from first-hand experience:
“It’s a home-like place but it’s also people caring for people to give them the best possible end of life experience along with their family members.”
Who gets to stay is a big question, and the answer is still a work-in-progress. The Nova Scotia Hospice Palliative Care Association together with the NS Health Authority has published written standards that will apply to all hospices as they evolve in Cape Breton, the Annapolis Valley, Truro, and Halifax. Residents must provide informed consent. No one can be refused entry because of their faith, race, or income. Below are the minimum standards individuals must meet:
Have a Nova Scotia Health Card
Be an adult living with a life-threatening progressive or terminal illness and be assessed as having a life expectancy of less than 3 months
Demonstrate an understanding that resuscitation and other life-sustaining interventions are not offered to hospice residents
Have explored all appropriate and available home supports
Confirm that the option of a home death has been considered and is not deemed feasible or desirable by the resident and/or their family
Require care that can be safely provided outside of an acute care facility
Pediatric cases are considered on a case by case basis, in consultation with the IWK, to confirm that the setting is able to meet the care needs of the child.
Long Term Care residents would typically have their palliative care needs met in Long Term Care, where they reside, with support from the Palliative Care Team if needed.
“Based on these standards, there is a provincial working group within the NS Health Authority that is developing eligibility and admission criteria,” says Glenna Thornhill, a registered nurse with 20 years experience providing palliative care to people in their homes. She’s been hired as the nurse manager for Hospice Halifax and will be part of a team making those gate-keeper decisions.
“It’s going to be based on need but we are still working through the ins and outs of that,” says Thornhill. “For example, people who need very complex medical care won’t be coming to hospice because we won’t have the staff who can provide what’s available in a hospital. Other residents may be alone in the world.”
Thornhill says a city the size of Halifax could use 30 hospice beds, based on a formula developed for palliative care. That said, Hospice Halifax estimates it will employ 15 staff — including a part time medical director who is a doctor, registered nurses, licensed practical nurses, continuing care assistants, a cook, a housekeeper, and a grounds/facilities manager — to care for ten residents.
Neal says the annual operating budget is estimated at $1.72 million — half funded by the province through a signed agreement with the Nova Scotia Health Authority, and the other half funded by donations from the community. Compared to the $1,100/day cost to stay in hospital, Neal calls $450/day for hospice care “a serious bargain for taxpayers.”
That budget doesn’t include money for the weekly bereavement support group Hospice Halifax has been running for nine years. Kyla Friel is a bereavement counsellor who is currently looking at best practices for training volunteers and conducting an online survey to see what other supports the public wants to make hospice “a place like home.”
People with language and translation skills, particularly French and Arabic, are “on the radar,” she says. She also plans to meet with faith-based groups and reach out to cultural communities “to find out how we can respect diversity and culture at hospice.”
“I tell people we need a million dollars a year from the community to run this thing,” Neal says with characteristic bluntness.
Meanwhile, the capital cost of building and equipping the hospice is ballparked at around $6 million. A $4.2 million loan was secured thanks to seed money from Pryor House, the QE2 Foundation, Rotary Clubs, and a dinner/dance annual fundraiser. This will be the fifth year for “Feeling The Love” and the first year the Feb.10 gala will be hosted from the Nova Centre. Neal is hoping for 1,000 supporters. Seventy per cent of the $250 tickets have been sold and $50 tickets are also available for the dessert and dance party with The Mellotones and Asia NuGruve.
After this fundraiser, half the capital budget still has to be fundraised. Hospice Halifax will launch a Capital Fundraising campaign later this spring aimed at securing big donations from philanthropists and the One Percent. But the bigger challenge may be finding the dollars from the 99 per cent to meet the annual operating budget (the portion not funded by the province) on a continuing basis.
Although it has taken Halifax a long time to establish a Hospice — a process organizers say was set back a full year when Capital Health was absorbed by the Nova Scotia Health Authority — Neal, Thornhill, and Friel are banking on the fact that once families have visited hospice, they will give back to ensure it remains financially sustainable.
“It’s not something you necessarily know until you experience it,” says Neal. “Then you become a supporter.”
Kyla Friel agrees.
“Hospice found me,” she likes to say.
After a decade in public relations with the provincial government, she left a secure job to enrol in a Masters level counselling program at Acadia University. That choice followed a series of deaths in her family including the sudden loss of her mother at age 50, and her grandmother who received palliative care in a long-term care home. Friel did her internship on 7A, the palliative care unit in the crumbling Victoria General hospital, where both the personal and universal aspects of palliative care converged.
“It’s a privilege to be with families when a loved one is dying,” Friel says. “I approach it with complete respect. It’s just such a human part of who we are.”
Editor’s note: this article has been updated to reflect more accurately for Hospice residency. Also, it misidentified Gordon Neal.