RITA H. LEE, PH.D

Norma Lindsey, administrator for St. Mary's Residential Hospice (left) and Lisa Collier, hospice director are pictured in front of the Transformation window in the hospice chapel.

As one drives up the curved driveway of St. Mary's Residential Hospice, no stark institution comes into view. Instead, one finds a homey, ranch-style English cottage with purple and green bushes landscaped around the entire perimeter of the house — a cottage which is St. Mary's Residential Hospice.

Norma Lindsey, administrator for St. Mary's Residential Hospice, explains, "In the 1960s, English physician Dame Cicely Saunders pioneered the concept of the hospice, the concept that enhancing quality of life is important for those near the end of life. Saunders established the first hospice in London, England. Therefore, in the late 1990s when St. Mary's Health System decided to build a hospice, it was designed with a welcoming, homey, English theme to it.

"Hospice care is done ideally in the home where most people want to spend their last days of life. But sometimes there are situations where healthcare needs cannot be managed in the home, yet bringing the person back to the hospital institution is not appropriate given the situation. A hospice facility is an alternative option that people have to get not only their physical, but also emotional and spiritual needs looked after. We aim to provide a home-like setting along with the care provided by our healthcare team," explains Lindsey.

"We have three levels of care which include acute care. St. Mary's Residential Hospice also provides care for the resident so that their family can simply get a break from caregiving, instead of having to permanently place their loved one in a nursing home. Our hospice also provides assistance for residents who may have no family available to help them with their care," adds Lindsey.

As one enters the foyer of St. Mary's Residential Hospice, there is a living room setting to the left with a working fireplace as well as nature scene paintings hung on the walls.

"Many of the framed artwork displayed are painted by local Knoxville artists," states Lindsey.

At the front of the foyer is a bouquet of three dozen fresh red roses given to the hospice by a son whose mother had just passed away the week before. To the right is a receptionist desk where Debby Sharp is serving as a new volunteer.

Sharp explains, "My mother spent her last two weeks here at St. Mary's Residential Hospice and I can't say enough good about it." Both Sharp and her sister felt they made the right decision in bringing their mother to the hospice, and Sharp says that this is the reason why she decided to start volunteering at St. Mary's Residential Hospice.

"The hospice couldn't survive without its volunteers," says Lindsey.

"Since we never want the patient to die alone, we have some volunteers who are willing to sit with the patients and hold their hand. In addition, our volunteers help in all sorts of ways including doing paper work, making festive patient gowns, and providing holiday meals for the hospice residents," adds Lindsey.

"The patients each have a private room with home furniture including a dining table with chairs, as well as a door wide enough to roll a bed outside onto to a covered porch overlooking the garden and woods," says Lindsey.

"Our healthcare team — including our nurses, nursing assistants, medical director, administrators, social workers, and chaplain — is actively involved in the total care of the patients," says Lisa Collier, hospice director at St. Mary's Residential Hospice.

"Another central component of hospice care is the family. We designed this hospice not only with the patients in mind, but also with the goal of making the families also feel at home here," says Lindsey.

"For example, we have niches with sitting areas as well as a family sitting room in each wing of the hospice. There is also a kitchen for the families to use. The chapel, which faces the open-air atrium gardens, is also open all the time," adds Lindsey.

Pat Green who manages the in-house hospice bereavement group notes, "We do not abandon the family once their loved one has passed away. We stay in close touch with the family and are available up to one full year after the patient dies."

"One of the unique aspects of hospice care here at St. Mary's is that, as part of the Catholic Health Care Partners, St. Mary's Residential Hospice is committed to embracing the patients' dignity and spirituality with integrity and compassion," explains Collier.

"Along these lines, at least one of the nuns from the Sisters of Mercy order comes to visit our hospice every day to spend time with the residents here at our facility. Even if the residents are not religious, the Sisters will offer to pray for them or just simply hold their hand and be with them," says Collier.

Lindsey shares her concern, however, that less than 25 percent of those who could benefit from the hospice care, actually get it — even though quality care is offered and can cost only a fraction of the costs accrued from a prolonged stay in a hospital's ICU unit. Furthermore, she states that most patients who come to the hospice have sometimes only weeks to live and are actively dying — too short a time for a relationship to be built between the hospice healthcare team and the family which may help the family and the patient more easily deal with all the aspects of end of life. With these and other concerns in mind, Lindsey and other hospice administrators traveled to Washington, D.C. last month to talk to Congress regarding hospice care and its benefits.

Hospice director Collier sums up the essence of the mission of St. Mary's Residential Hospice, saying "One of the most compassionate aspects of St. Mary's Residential Hospice is that our mission is based on the concept of sacredness of life — even in the end of life. It's a privilege to serve the residents with this concept at heart."