by Gia Martucci
The patients at an AIDS hospice facility in San Francisco were nearing the end of their lives. A volunteer visitor was nearing a turning point in hers. Cathy Conway had enjoyed success in the corporate world early in her career but was looking for something more meaningful.
“The connections I made, I got to know people on a heart level,” Conway said. “That can take years. But because the people here didn’t have that long, connections were formed within hours. I thought, ‘This is something I want to explore.”
Conway has done more than that. Now, the CEO at Hospice of Santa Cruz County, she is a passionate advocate for community-based end-of-life care that recognizes the whole person—not just the patient.
Typically, hospice involves care provided by a full team—physicians, nurses, social workers, home health aides, spiritual counselors, bereavement counselors, and volunteers. While doctors and nurses tend to medical issues, social workers provide emotional and practical support, as well as information about local resources. Home health aides provide personal care, such as bathing, shaving, and hair washing. Volunteers provide respite care, run errands, and often simply provide companionship.
“The purpose of hospice care is to support patients and families throughout the dying process and to provide support for all spheres of that experience, including physical symptoms, emotional, psychological, relational and spiritual issues,” says Gary Pasternak, M.D., associate medical director of Mission Hospice & Home Care in San Mateo, California.
In addition, hospices provide surviving family members with grief support; many offer free grief support groups, as well as workshops on death, grief, and advance care planning for the community at large. These opportunities help normalize the discussion of death and dying, and introduce people to hospice long before it’s needed. However, these additional resources vary greatly between hospices. Offerings, or lack thereof, are often indicative of each hospice’s priorities: people or profit.
“For-profits generally have more minimal grief support offerings. That’s just an example of how they prioritize what they do differently,” says Michael Milward, CEO of the California Hospice Network.
“Unlike many for-profits, most nonprofits have been serving their communities for more than 40 years,” says Milward. “They are deeply connected to their communities and can respond to the needs of those communities without concern for shareholders or investors. But they’re in trouble.”
While many community-grounded nonprofit hospices have a small footprint that affords them a rich connection to their local communities, their typically smaller size can pose a very real problem when larger for-profit hospices move into their cities. “In order to preserve the legacy of these cherished community hospices, we must find power in numbers,” believes Milward.
California Hospice Network, a strategic partnership of like-minded nonprofit hospices, is forging a path forward through teamwork.
California Hospice Network currently includes three member organizations and serves over 10 counties stretching from the Sacramento Valley to the Central Coast. Comprised of YoloCares in Davis; Mission Hospice & Home Care in San Mateo; and Hospice of Santa Cruz County in Santa Cruz, these three agencies have found commonalities in their mission and are working together to protect not only their storied legacies but those of all non-profit hospices in California.
Together as a singular business entity, they can contract with larger health systems and care providers, take advantage of cost-saving measures, and share best practices. For the sister hospices of the California Hospice Network, the benefits of membership are serving a greater purpose.
“In order to bring meaningful programs and services to our communities, we must remain relevant in a changing health care climate,” urges Conway. To the community, that relevancy translates to providing care when it’s needed most. For nonprofit hospice leaders, that relevancy speaks to providing offerings for seriously ill people who aren’t eligible for hospice care by Medicare guidelines but need the support that the team approach of hospice care provides.
“After experiencing the comprehensive support that hospice provides, many people say that they wish they’d called us sooner,” explains Conway. “My message to the community is: know us before you need us.”
Conway said when she is in the community, in places like grocery stores, people will see her badge from Hospice of Santa Cruz County and spontaneously share their stories. She said there is a need for someone to receive those stories, a need for someone who understands what it’s like to deal with the death of a loved one.
“That’s what we at the California Hospice Network want to be,” she says. “The ones who understand.”
To learn more about CHN, visit https://www.cahospicenetwork.org/