Quality of life has long drawn people to the Sandhills. To that you can add end-of-life quality, since Hospice House opened in Pinehurst, in 2011.
Still, as applied here, both “end-of-life” and “quality” beg elaboration. Because, contrary to public opinion, Hospice House is not solely a place to die.
“Until the need arises, people may not know what’s available,” says Tina Gibbs, FirstHealth Hospice & Palliative Care director. “We need to educate the public about that.”
When someone with a terminal diagnosis experiences an acute medical phase — often pain management — they might be admitted until the problem is resolved, then return home improved, perhaps able to rejoin family activities. Others remain for days, weeks or until death.
The 11-bed, 16,000-square-foot facility has become a place of reconciliation, even peace — or not. Hospice House Assistant Director Jenny Snead, with 15 years of experience as a home hospice nurse, observes how a terminal illness can bring people together or exacerbate unresolved issues. One divorced couple remarried in the chapel, then hosted a reception in the family room shortly before the husband died.
Alternately, should tensions arise, the buildings and grounds provide space for discussion.
Regardless of prognosis, emphasis centers on patient comfort in a setting more like a hotel than hospital. Schedules don’t apply. Meals — whatever the patient wants — come whenever. Snead recalls another couple whose first date was at Dairy Queen. “On their anniversary our chef picked up stuff” from there.
The house never closes. Visitors and family come and go, sleep on reclining chairs and sofa beds in patient rooms, take breaks in the lounges, heat up a meal in the kitchen, retreat to a solace room. Pets may visit.
Other little-known parameters: Referrals are invited from anyone directly involved with a terminal diagnosis. Patients need not be from Moore County; occasionally a patient from elsewhere is admitted to be near family support. Illnesses other than cancer are represented. Hospice House accepts Medicare, Medicaid, private insurance; however, no uninsured patient who meets criteria is turned away because, Gibbs says, “The end of life is not the time to worry about how to pay for health care.”
And with a nurse-patient ratio of about 1-5, nobody waits or feels rushed.
“I had never dealt with hospice,” says Mamie Allen, an educator who lives in Southern Pines. “I didn’t even know it was here.”
The family was in shock when Allen’s sister Vivian Monroe received the diagnosis: uterine cancer, which recurred after surgery and chemotherapy. The close-knit siblings were advised that nothing more could be done. “We wanted to take her home,” Allen says. “We had no idea what we were in for.”
Allen recalls that Dr. Michael Sundborg, Monroe’s gynecological oncologist, had a better idea.
“Hospice is a house, not a hospital,” Sundborg explains. “The facility is conducive to families — more important than dispensing the medicine,” because social, psychological and spiritual needs are met. Sundborg also finds that people may live longer in hospice care, no matter where administered.
“When we arrived, we found the staff nurturing and caring,” Allen said.
“It is a calling, to work with people in end-of-life situations,” Gibbs, a social worker, says. Nurses must have solid medical credentials with on-site training in hospice philosophy and methods.
Patients without family are attended by volunteers. Non-institutional furnishings that disguise medical equipment, soothing Earth colors, flat-screen TVs, cheerful art, ambient lighting, a patio outside each spacious room, therapy dog visits, spa tub and hairdressing station — even a children’s playroom — enhance the human element.
Hospice/palliative care for the terminally ill has been practiced for millennia, mostly by religious orders. Cicely Saunders, a nurse who became a physician, initiated the modern hospice movement in England, in the 1950s. The first American hospice residence was established in Connecticut, in 1980, by the dean of Yale University Nursing School.
Hospice developed as a system of care in other settings including patient residences, nursing homes and hospitals. An estimated 1.6 million Americans receive care in some form annually, the National Hospice and Palliative Care Organization reports.
In North Carolina, the figure approaches 35,000 patients a year. Newer residences in Asheville, High Point and Pinehurst reflect the trend toward magazine-quality interior design.
The $13.8 million Pinehurst facility off U.S. 15-501 consists of Hospice House, an administration building housing the Grief Resource and Counseling Center, offices for the home care agency serving Moore and Montgomery counties, and a glass-walled chapel overlooking the pond available for meditation, prayer, memorial services. The chapel contains no religious icons. Participants may bring their own. The Allen family donated hymnals in memory of their sister.
The 38 acres, a former RV campground, was a partial gift from Michelle and James Kirkpatrick. Landscaping, fountains and gardens suggest strolling, picnicking, watching waterfowl skim the pond.
Since 2012, FirstHealth Hospice House and home care together have served 3,446 patients. The number of beds at Hospice House is determined by a formula resulting in a Certificate of Need through the N.C. Division of Health Service Regulation. Plans for expansion beyond 11 beds were built into the design. Snead says a bed is usually available within 24 hours.
Mamie Allen’s sister died in June, three weeks after admission.
“I never saw anyone pass away,” Allen says. “The staff talked us through it. All our questions were answered with patience. We accepted (her death) better because we were here in a serene place, like home. We can function better without her, now. ”
Hospice involvement doesn’t end with death. Families are offered 13 months of grief counseling, with special programs for children.
Sundborg calls Hospice House a wonderful asset to the community. “I believe in talking about palliative care before it’s needed,” he affirms. “Because part of our lives is passing away.”