TORONTO, Ontario / The Globe and Mail / Health & Fitness / August 3, 2011
By Kim Mackrael
A new Toronto hospice dedicated to caring for people in the final weeks of their lives will accept its first patients in August, despite a warning that it should not count on provincial health-care dollars to pay its bills.
Kensington Hospice, a partnership between the Princess Margaret Hospital and the Kensington Health Centre, is designed to provide a supportive, home-like environment for people who are dying. A common living room and kitchen will offer a place to cook or socialize, and a team of nurses, counsellors and volunteers will be on hand to support the patient and family members.
When Kensington Hospice opens its doors on August 8, it will add 10 new beds to the city’s residential hospice roster – about a 30-per-cent increase to the number currently available, according to the Kensington Health Centre.
But that still won’t be enough to meet demand in the city, said Rick Firth, executive director of the Hospice Association of Ontario. “The demand far outstrips the availability,” he said. “Right now, someone in central Toronto really doesn’t have the option if they can’t stay at home. They end up in acute care.”
Mr. Firth estimates it costs about twice as much to care for a patient in an acute care bed than it does in a hospice.
This year, the Ministry of Health and Long Term Care announced it will increase its funding to some hospices to cover the full salaries of nurses and personal support workers. But Health Minister Deb Matthews said she doesn’t plan to add Kensington to the list of facilities the province supports.
“At this point it’s not in our plan,” Ms. Matthews said. “Kensington decided to go ahead without assurances they would get government funding.”
She said the ministry is reviewing hospices to determine how they should be funded and whether they should be licensed.
“We really believe in the hospice model and the care the hospices provide,” she said. “We’re taking a very close look at the different pieces ... to find out what we need to do to fill the gaps.”
Kensington Health Centre president Brian McFarlane said he hopes the hospice will receive provincial funds in the future, but in the meantime, the Kensington Foundation will cover operating costs, estimated at $1.6-million a year.
Tucked away on a quiet, residential street just west of the University of Toronto, the hospice was originally built as the Chapel of St. John the Divine in 1888, and served as a hospital for women for several decades.
The Kensington Health Centre spent three years remodelling the building in an effort to maintain its vaulted ceiling and stained-glass windows, while adding the modern amenities of a new medical facility. Each room is equipped with a bed, a wall-mounted television set, a dresser and a chair that folds down into a bed to allow a guest to stay overnight.
Debbie Emmerson, a registered nurse who will direct patient care at the new hospice, said the focus is on helping patients find peace and comfort at a difficult time.
“It’s not just about looking after the pain and nausea and those other things,” Ms. Emmerson said. “It’s about creating [an opportunity to enjoy] life and looking at what is it that they want to accomplish because life is still happening.”
Though hospices are generally equipped to handle basic patient care, they usually don’t have all of the life-saving tools a hospital does. That means, for example, that while staff at Kensington Hospice can offer oxygen to ease patients’ breathing, they won’t have ventilators on hand to resuscitate them if they are no longer able to breath on their own.
Gary Rodin heads the department of psychosocial oncology and palliative care at the Princess Margaret Hospital and is the academic director at the new hospice. He said many patients choose hospices because they don’t want to receive aggressive treatments to prolong their lives anymore, and they want their friends and families to be free to visit at any time.
“In most areas of medicine, providing better care means more expensive care,” Mr. Rodin said. “Here’s the paradox, actually. We can provide better care, less expensively than a general hospital and free up those beds for people who do need to be looked at [in a hospital].”
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