Recently, I was dismayed to read an article about plans for a hospice in North York being challenged by some local residents. In the article, the residents claim “in venomous terms” that “they should build it some other place, and not in our place.” These objections led to a local planning review panel.
One of their more facile arguments is that it “does not fit the existing physical character of the neighbourhood,” which raises issues of “discrimination and exclusion.” They also make “pseudo-science” claims about “groundwater getting pushed off the site” and that “neighbours are going to lose their houses.” And then there’s the old trope about traffic and noise, even though Highway 401 is right there.
While I was pleased to hear that the Neshama hospice was able to clear this initial hurdle, I was deflated to hear an appeal has been launched by this same group that will delay construction even longer. As such, I am compelled to write in support of the Neshama hospice.
First the disclosures. I am the medical director for the Hospice of Windsor and Essex County. I have known Dr. Sandy Buchman, the lead of Neshama, for many years and consider him a personal friend, mentor and role model.
Be that as it may, I would love to have a hospice in my backyard and if North York won’t have it, consider this my open invitation to build in my backyard (it’s a bit of a tight squeeze but I think we can do it, if we get creative …)
Let’s start with some definitions.
Palliative and hospice care are often used synonymously and interchangeably. For clarity, palliative care is the umbrella term that refers to the care provided to patients with a life-threatening illness, preferably from the time of diagnosis until end of life. Hospice care is synonymous with end-of-life care. This typically occurs in either a residential hospice or a patient’s home. Some residential hospices have community outreach programs that provide home hospice care with the residential hospice available as a backstop.
Palliative care is a holistic approach to patient care facing a life-limiting illness. It provides compassionate, patient-centred care that focuses on patients and their families. Palliative care has been shown to significantly improve a patient’s quality of life, decreased stress and burden on families and caregivers while actually increasing a patient’s survival in some cases. These benefits have been shown in both cancer and non-cancer patients.
Second, hospice care contributes to the sustainability of our universal single payer health care system. Hospices provide care that is much less expensive than acute care hospitals. Combined with a community outreach homecare program (which is even more cost-efficient), hospice care saves the healthcare system money that can be reinvested in other areas like mental health, addictions and preventative care, just to name a few. Hospices make so much sense, we built our second, Canada’s first satellite hospice, in 2016.
Third, MPP John Fraser advocated using “hospices as hubs” for palliative and end of life care in his 2016 Palliative and End-of-Life Care Provincial Roundtable Report. This is no coincidence. I attended his roundtable sessions and pitched this idea based on our experience here in Windsor. Our hospice functions as a touchstone for “all things palliative” in Windsor-Essex. We have one phone number and our community knows how to get a hold of us when it needs to. Our palliative medicine program works “hand in glove” with LHIN homecare services to provide 24/7/365 care. Our hospice is a key component of this program as it provides a home for patients when home is no longer an option.
Tell me more…
The Ontario government is currently in the process of expanding hospice care across Ontario. And we sorely need it. It is recommended that we have one hospice bed for every 10,000 residents. Based on a population of 14 million, that means we need at least 1,400 beds. Currently we have less than 300. While we are nowhere close to where we need to be, the Ontario government committed to building and funding an additional 193 hospice beds.
Finally, our hospice in Windsor is not just a hub, it functions almost like a community centre. Residents of Windsor-Essex use our facilities routinely (pre-COVID) for meetings, gatherings, educational sessions and social events. My son had his fifth birthday party in our gymnasium (yes, we have a gym) with a local “Zoo2You” party organization. We have had weddings and baby showers on our premises. We host classes in karate, yoga and mindfulness. We regularly provided educational offerings such as our Breakfast Club and Evening at the Hospice to promote and educate around hospice palliative care. Our hospice is a training centre for doctors, nurses and social workers to ensure they have training and competency in palliative care.
And our hospice is located in the middle of a residential neighbourhood.
Death and dying is part of life. But we live in a death-fearing society. To help with this, I often explain to patients and families that life is like a good book. It has a beginning, a middle and an end. Hospice palliative care is about writing the best possible ending to that book for our patients. And just because the end may be sad, it does not mean it can’t still be a good one.
So, if you still don’t think having a hospice in your backyard is a good idea, please feel free to send it our way. I, for one, would be glad to have it in mine.
But a better solution would be for the residents of North York to stand up and demand that the construction of the Neshama hospice be allowed to continue without further unjustified obstacles. The benefits for patients facing a life-threatening illness greatly outweigh the harm of further delays.