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Bobby's hospice.

EDITOR'S NOTE: In an effort to highlight hospice care in New Brunswick, we approached both Bobby's House (Greater Saint John) and Hospice House Fredericton to share their journeys to conception and care services provided to patients and families.

Briefly share your Hospice House journey- from conception, to opening its door, to caring for patients and families in the community.

Hospice Greater Saint John has provided valuable palliative care services to our region for 33 years. In the beginning, we provided a volunteer visiting and support service as well as community grief support services to families coping with loss.

The vision of Bobby's Hospice was launched with the release of the Senate Report, "Quality End of Life Care: The Right of Every Canadian" in 2000. After ten years of research and development, we proudly opened Atlantic Canada's first 10-bed residential hospice in the former St. Joseph's Convent on November 1, 2010. Our home is named Bobby's Hospice in honour of a 20-year volunteer, Catherine "Bobby" Lawson, who provided a significant donation to help us achieve our dreams of an in-patient residential hospice.

Since opening nearly six years ago, Bobby's Hospice has:

* Provided quality, in-patient palliative care to 610 patients who could no longer stay at home and did not require acute hospital services;

* Freed up 16,500 hospital bed days at the Saint John Regional Hospital;

* Provided the NB Government with over $13M in reduced in-patient palliative care costs.

Today, Hospice Greater Saint John owns and operates both Bobby's Hospice, and The Hospice Shoppe, a second-hand retail store that helps to fund care at Bobby's Hospice. In addition, we continue to offer comprehensive grief support services to persons in the community coping with the loss of a loved one. We have a staff of over 35 dedicated healthcare and retail professionals and a team of over 170 volunteers dedicating their time and talents to both Bobby's Hospice and The Hospice Shoppe.

Hospice is a shining example of what can be achieved with innovative partnerships between government, charities and communities. Our partnership with the Department of Health provides $730,00 0 in funding and our generous community donates $1M every year to help us provide care at Bobby's Hospice.

How does hospice care differ from palliative care units in the hospital setting?

A residential hospice offers a non -institutional, home-like environment which has a significant amount of space dedicated to family use. We welcome family to be here 24-hours a day and provide them with full kitchen, living room, bedroom and bathroom facilities.

The focus of Hospice care is on comfort, not cure--and on life, not death. At Bobby's Hospice, our motto is "It's your journey, your way." Our goal is to make each person's last weeks and months of life as comfortable as possible while also providing support to family members and friends.

Hospice is about dignity, respect, comfort, peace and hope. It is about celebrating life and enhancing the quality of living. At Bobby's Hospice, we help to make a patient's last wishes come true, like spending a weekend at the camp, or taking a special trip with loved ones, etc.

What would RNs and/or other health providers benefit most knowing about hospice care?

100% of us will die at some time and in some way. Less than 10% of us will die a sudden death from an accident, heart attack, stroke, etc, leaving over 90% of us in need of palliative care at the end of life.

A community residential hospice is a cost effective way to provide quality, in-patient palliative care to the 50-70% of people dying from advanced illness who need 24-hour medical and nursing care outside of the hospital setting. The cost of care in a 10-bed residential is $465/day compared to $1,000/day in a hospital setting. Government's cost is $200/day with the community funding the additional $265/day through donations and support.

Our care is in keeping with Canadian standards. It does not include physician assisted death, nor does it hasten or prolong death. We aim to relieve suffering and improve the quality of life with expert pain and symptom management, education and comprehensive support and care.

If you or a loved one cannot stay home through the end of life, a residential hospice offers a home away from home with high quality, personalized care and support. At Bobby's Hospice, we provide compassionate care that celebrates life and serve as a very cost effective approach to in-patient palliative.

How would an RN go about helping a patient seek hospice care?

Bobby's Hospice is a 24-hour/7-day a week admitting facility. Patients are admitted by a physician, either through a family physician if the patient is at home or through the Palliative Care Unit if the patient is in hospital. Extra-Mural is often the conduit in the community between family physicians and Bobby's Hospice, helping to facilitate direct admissions and avoiding unnecessary hospital visits. Nurses are always welcome to call Bobby's Hospice if their patient is in need of in-patient hospice services. Our specialized team can help fast-track admissions.

In what areas does hospice care specialize vs. other health care institutions?

Hospice palliative care is specialized end of life care. Physicians and nurses who work at Bobby's Hospice have specialized training and expert skills in advanced pain and symptom management, prognostication, advance care planning, psychosocial/spiritual care, grief and bereavement and self-care to prevent compassion fatigue.

Many people falsely believe that ending lifesaving treatments and entering a hospice palliative care program will hasten death. Often, the opposite is true. In fact, medical research has shown that patients receiving early hospice palliative care had a better quality of life and lived longer than those who received standard, less aggressive care at the end of life, according to a study published in the New England Journal of Medicine in 2010.

We have repeatedly seen evidence of that here at Bobby's Hospice. Patients have been admitted with short life expectancies and with the expert pain and symptom management and comprehensive support provided by our specialists, the patient lives longer and better.

At Bobby's Hospice, we had a patient admitted with a life expectancy of two months or less. Within 24 to 48 hours, our experts had his pain and symptoms under control and he had improved quality of life, so much so that he was able to take his wife on a second honeymoon to Niagara Falls, Ontario two months after being admitted to Bobby's Hospice. His life expectancy turned out to be 10 months of quality time with loved ones.

Hospice care can't always add days to life, but we can relieve suffering and add life to days! In the end, it is what we all want for our loved ones and ourselves.

Caption: At Bobby's House, patients receive visitors from organized children's groups.
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Author:Johnson, Sandy
Publication:Info Nursing
Date:Sep 22, 2016
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