Hospice director Dr. Vicky Segura, a Sister of Bon Secours, visits with a patient. Photo by Black Horse Studio
After a 13-month battle with ovarian cancer from 2007 to 2008, Tony Markel's wife, Susan, spent the final four weeks of her life under in-home hospice care through Bon Secours Richmond Health System.
"Hospice was a wonderful thing," Markel says of the program that served 1,700 patients in 2011. "It left a lasting impression on us." The Richmond-area developer and vice chairman of Markel Corp., along with his business partner, Jack Cullather, recently donated 6.7 acres valued at $400,000 in Bon Air for the construction of greater Richmond's first residential hospice house. The Bon Secours Community Hospice House campaign has raised about $1.6 million toward a $5 million goal for the facility. Construction could begin in 2013.
"We're all going to face the day that we'll be passing away," Cullather says. "Might as well go in a quality way of life." The honorary campaign co-chair lost his 21-year-old son to multiple brain tumors in 1992. In 2003, his wife, Jean, spent the last two months of her life under Bon Secours hospice care before dying from a brain tumor as well.
The freestanding community hospice house will serve patients and families throughout the region, regardless of which physician, hospital system or hospice program initiates a referral. The 16-bed facility will provide a home-like setting for all patients experiencing end-stage illnesses.
"It is sorely needed in this community," Markel says of the hospice, which will participate with Medicare, Medicaid, insurance companies, individual families and philanthropic communities. Approximately 39 percent of Bon Secours' hospice patients are diagnosed with cancer, 13 percent with end-stage cardiac issues, 11 percent with lung disease, 10 percent with dementia or Alzheimer's, and 7 percent with stroke-related effects or coma.
According to the U.S. Department of Health and Human Services, two-thirds of Americans older than 65 and three-fourths of those older than 80 have multiple chronic diseases. In the past four years, the number of patients receiving hospice care has increased steadily, with an estimated 1.58 million hospice patients in 2010, according to the National Hospice and Palliative Care Organization.
"As the baby boomers begin to come into that age where hospice becomes an option for themselves — and that's not far down the road — they understand what the meaning is of quality of life versus length of life," says Spence Levine of the Hospice Foundation of America. "Hospice is not going to change the outcome, but it can make the journey a lot less fearsome and painful."
Current hospice-care options in Richmond include about 15 in-home providers through local health systems, community-based programs and national chains.
A 15-bed inpatient hospice facility at Retreat Doctors' Hospital provides short-term aggressive care. There aren't any options for patients who don't require hospitalization but need frequent monitoring.
"We're very poorly serviced for people who need that level of care," says Brenda Clarkson, executive director of the Virginia Association for Hospice and Palliative Care. The aggressive-symptom-management level accounts for only about 5 percent of all hospices throughout the country.
The planned community hospice will follow the same general inpatient criteria used throughout the Bon Secours system, so the length of a patient's stay will depend on his symptoms. The facility will have a chapel, reception areas, a family kitchen and meditation gardens, among other features. It will be led by medical director Dr. Vicky Segura, a Sister of Bon Secours, and will include chaplains, hospice aides, nurses, physicians, social workers and volunteers.
"It's a great sense of relief for family members who perhaps are caring for somebody at home and it just becomes very difficult for them to manage," says Anne Marie Mack, a senior vice president with Bon Secours Richmond. "It's a place where people can feel comfortable, and get the excellent clinical care that they need."