Hospice history

On August 18th actual construction of a long-awaited hospice in Kentville was announced. For as many people as are celebrating this news, a significant number are in the “about time” column. Here’s a history of this lengthy project so people can track the glacial progress of the hospice:

1997 – Survey determines the need for a 10-bed hospice.

1999 – Foundation formed with goal of raising $700,000 for hospice.

2000 – Sept. 8th Chronicle Herald article says VON Kings Hospice Foundation raised $150,000 towards 10-bed hospice.

2005 – July: Hospice Working Group formed.

2006 – October 3: An “Extraordinary General Meeting” held to approve a name change to the “Valley Hospice Foundation”.

2006 – Fall: The Valley Hospice Foundation (VHF) joins Valley Regional Hospital Foundation to raise $8 million via the Our Community Our Health Capital Campaign. The merged campaign starts in 2008 with what, in 2010, is described as a “quiet phase”, which excluded the public. In a confusing description the campaign funds “were to be distributed 25% community portion of the redevelopment of Valley Regional Hospital, the purchase of medical equipment and 100% funding requirements for the building of a Hospice and Palliative Care Centre.”

2008 – VHF directors agree funds are to be used for the purpose intended, that surplus funds are to be invested to maximize return with limited risk, and that administrative costs of the foundation and joint capital campaign should not exceed 7% over three years. (In 2012 this was changed to 15% over five years. In 2013 this was amended to allow campaign administrative costs to rise to 17% over the span of the campaign period, ending March 31, 2014. There were years when VHF expenses run 36, 44 and 180% of revenues.)

2009 – VHF Annual Report starts using a “conceptual image” of the hospice, suggesting planning and design has started.

2009 – Hospice’s projected cost had risen to $4.2 million. The Our Community Our Health campaign has that in the bank.

2010 – February: Formal public launch of Our Community Our Health.

2011 – July: Two palliative care rooms open in Valley Regional Hospital.

2012 – Spring: Hospice website launched.

2013 – September: A design consulting services contract awarded for the Hospice and Palliative Care Centre.

2014 – March 31: VHF chair’s Year in Review says, “97% of our financial goal has been realized and the reality of our Hospice Centre is imminent.”

2014 – June 11: CBC quotes VHF chair Diana Patterson, “We were very, very close. Very close indeed. We had enough money to start building.” The “good delay” in moving forward she placed on the Liberal government’s move to merge nine district health authorities into one provincial health authority.

2015 – March 31: Plans for the hospice are given to Minister of Health. The Our Community Our Health campaign is $45,000 short of its $8 million goal.

2015 – July 6: CBC reports VHF reached its $4 million fundraising goal and will continue to fundraise.

2016 – February 3: VHF chair tells CBC they have a meeting with the Nova Scotia Health Authority. “Our money is in the bank and we’re waiting for the go.”

2016 – August 19: Convenient photo op is arranged so the “go” can be announced.

People can be excused for being sceptical about the announcement. In typical fashion, the people on hospital hill and those ensconced in the corporate bunker in the Valley Industrial Park spent decades talking amongst themselves. They have spent two decades having meetings, forming committees and discussing working group composition, with some fundraising thrown in.

The timeline for the hospice doesn’t show any burdensome workload. While their annual reports are full of thanks for the tireless work of their volunteers, that didn’t alleviate the pain and suffering of people in need.

Now that an announcement has been made, it comes with an equally languid timeline. A hospice won’t open until 2019! Why? They’re not building a battleship or a rocket. It’s essentially a modified motel. The 62-bed Shannex Orchard Court, located several hundred metres from Valley Regional Hospital, was constructed in 18 months and that included time to remediate old railroad lands. Orchard Court is six times the size of what was announced and built in half the time. Across the hospital parking lot is Fidelis House. It accommodates 20 people a night and was constructed in less than a year.

Why does the hospice need three years? The VHF commissioned plans in 2013, they have had the full construction money for over a year, in February they had their final round of meetings, so had an extra six months to modify any plans. If they were efficient and effective they would have been ready to brake ground with their announcement. Construction could have started now and a shell weather tight before the snow flies, with work continuing throughout the winter.

It doesn’t give one confidence that this will be on budget – and the new costs are curiously $900,000 less than those budgeted a decade ago – and on time. Cynics remember that on November 28, 2012, then Health and Wellness Minister David Wilson came to Kentville with a $1 million promise to fund a new dialysis unit at Valley Regional Hospital. Tim Guest, Annapolis Valley Health Authority’s VP of acute care, now with the Nova Scotia Health Authority, told local media it would take two years before the unit opened. Four years later there is still no dialysis unit and the ground hasn’t been broken on it.

By 2019 we could be on a new government, which could present a whole new range of excuses and delays. At the very least a new hospice should open in 2017 on the anniversary of the original survey which found the need for one.

A postscript – since no designs were commissioned before 2013, how did the VHF come up with a $4.2 million price tag for a hospice? Was this an invented number or based on some actual model?

This entry was posted in Uncategorized and tagged , , , , . Bookmark the permalink.

8 Responses to Hospice history

  1. Bubbie says:

    I know everyone speaks highly about hospice but I have some misgivings about it. After two years as a resident in a long-term care facility, my mother after taking a turn for the worse passed away peacefully in hospital under the care of a palliative care team. She was kept comfortable without any pain and it was all covered under MSI.

    It appears when it comes to funding, the taxpayer is not only footing the bill but donations are solicited along with families footing the bill for care of a loved one while in a hospice facility. The elderly are usually targeted and are being sold something that should be paid for by the government after paying years of taxes for health care.

    Speaking as a spokesperson for the ACE Team that has been advocating for quality care for the elderly in long-term care situations, because I have been involved for so long as an advocate for the elderly, I have become a bit cynical about the intentions people have in creating charities and not for profit health care facilities including the end of life hospice facilities concerning the elderly.

    One such group attended one of our ACE Team meetings several years ago and spoke to our ACE Team looking for support for a not-for-profit hospice facility they wanted to build. Of course, it would involve government funding and donations from the public plus there would be a fee attached for end-of-life care which was/is being provided in the hospital for “free” under the national health act.

    A perfect environment is being created for someone and the government to make and save money, again, at the expense of the elderly. We are beginning to be faced with Bill C-51 prompted by the “Dying with Dignity” movement, plus funding cuts our provincial governing Liberals are making to long-term care will further the argument to increase support for building more hospice facilities. The elderly are already, basically being denied health care for chronic ailments through long wait times and delays and is placing a burden on acute care.

    Leo Glavine’s Liberals are cutting long-term care to the bone with their austerity measures resulting in five dollar meal budgets and staffing layoffs resulting in further neglect elderly residents must endure. Instead of long-term care facilities being a place to thrive they are quickly becoming places to die. It is quite easy to see the direction we are heading and what future health care is looking like for the elderly and it ain’t pretty.

    • Figures quoted in the press say an acute care hospital bed costs $1,000, whereas a hospice bed is priced between $400-$450/day, thereby saving the public purse $550-$600/day. I am surprised to read your thoughts that hospices may charge for care.

      • Bubbie says:

        As I have indicated in my comment, people create things with good intentions but do not realize the consequences of their actions.

        If governments can see a way to save money they will do it. As it stands, now one can get good palliative care in the hospital paid through our health tax dollars. Yes, there is the argument money can be saved by allowing people that are dying to do so in a hospice, but don’t think for one minute that it will bear no costs to families. Eventually, it will be like everything else when greed kicks in, it will be a huge financial drain on families.

        I can give examples where programs have been started that saved the government millions of dollars only to have the Government cut funding in order to save more money.

        One prime example is Care By Design created to provide 24/7 physician services for long-term care facilities that allowed many long-term care residents to have access to a doctor that previously had no doctor caring for them. This program saved the government $6 million in last year’s budget through cuts in Pharmacare that doctors saw were an over-prescribing of prescription drugs to long-care residents and needless ER patient transfers because Care by Design doctors was able to adequately care for the residents in the facilities. This didn’t stop the government funding cuts to long-term care facilities.

        There have been other groups all doing the same charitable that have been privately created and are now receiving government funding and continue to drain valuable health tax dollars away from patient centred care.

        Governments love to see private development that will save them money and eventually privatization creeps in and fees are downloaded onto cash-strapped families that have to choose between prescription drugs and food. It has been already expressed by the group who addressed The ACE Team for their proposal to create a hospice several years ago that a nominal fee would be applied for “administrative costs. ” Just like private for-profit and not-for-profit long-term care facilities that receive the exact same government funding and charge the same daily rates for all long-term care residents so too will private “charitable” hospice facilities.

      • Good to know. My previous comment was to illustrate an economic argument for government to embrace the speedy construction of hospices. Not to term them into a revenue stream, but to see their contribution to controlling costs while providing a gentler way to handle a difficult stage of life.

  2. woof says:

    Private donors raised the money…and more. Now that the government is involved wait for the timelines and construction costs to EXPAND. Sad.

  3. Bubbie says:

    I agree that there needs to be a kinder, gentler way to handle a difficult stage of life. I have seen the bad and the good side of the end of life with both of my parents. While my mother received beautiful end of life palliative care by a very compassionate medical team well versed in end of life training, I can’t say the same for my father who also passed away in hospital from the ravages of cancer. He should have been in palliative care but instead, he was in an ENT (Ears, Nose and Throat) ward where he had a very cold, unfeeling male nurse that was only interested in getting to his break.

    It was around 2am when my father took a bad turn. It seemed like he had a mini stroke where he could hardly talk. The male duty nurse came in on a routine call, placed some pills in my father’s hand and was supposed to take them with a glass of water. When my father tried to take the pills he couldn’t swallow; the water and pills fell out of his mouth. He could only mumble some words, as he was trying to tell me he couldn’t swallow.. I told the male nurse something was happening to my Dad. The male nurse ran out of the room without saying a word. I thought he was going to get a doctor and waited for some time before I realised he was not coming back. Being late at night, it took me about fifteen or twenty minutes to track down a nurse who was quite alarmed at the state my father was in and took no time contacting the staff doctors. They administered some morphine but it did not seem to be quite a proper amount as my father laboured breathing with his head rocking for about three hours before he passed away. The image of my father dying will remain with me for the rest of my life. It was really painful to watch. it was a dimly lit ward and staff didn’t seem to be around when you needed them, leaving my Mother, Uncle and me alone with my dying father.

    If there is a need for hospice care and would help to reduce costs to the healthcare system, then it should be carefully monitored so that a well trained staff is present and it never incurs out of pocket expenses for grieving families in the name of profit for hospice facilities and any money saved for the health care system should be placed back into the system providing better quality patient centred care instead of doling it out to corporate welfare for private infrastructure as in the case of $260 million shipbuilding facility for the Irving Shipyard. The same year the Irvings received money for their shiny new building the NDP cut over $100 million in health care and another $100 million to education.

    I would never want to see hospice care wind up to be the horror story long-term care is proving to be with operators becoming staggeringly wealthy at the demise of the elderly and the dying while providing minimal care not fit for human dignity.

    • Sadly, there are so many horror stories around the death of those we love. Health care have been able to hide behind “privacy regulations” to hide the scope of lack of care. Survivors have been segregated, told their experience wasn’t the norm and was a one-off abbreviation. As a result, survivors have suffered in silence and not told their stories. That hides the dept of the problems with elder and end-of-life care.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s