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.
Ok but…
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.
Go on….
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.
Sounds good…
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.
The comments section is closed.
A few years ago, The Toronto Commandery Hospice was donated land in an industrial area, an employment zone. Across the street is a long term care facility. The City and neighbours blocked construction because it was improper land use. City planners were dead against us. Why? God knows.
We now plan to locate on a non-hospital healthcare park next to West Park Healthcare Centre.
It is an uphill battle all the way.
Neshama Hospice is well designed to fit with the community in which it is proposed to be built. It is also a much needed resource to care for people within the adjacent neighbourhood. It will be a wonderful home like environment that will provide compassionate care near where people live. I hope delays will be minimized and have no doubt that like Hospice Windsor, Neshama Hospice will be a welcomed hub for community care.
Well said Bob
Another great piece of journalism, Dr. Cargill! Thank you!
Thanks Joan. Did I just get promoted to journalist? ;)
Thank you for this, Dr. Cargill. The controversy is sadly reminiscent of the early neighbourhood protests against the 14-bed St. John’s Hospice on the UBC campus in Vancouver, which survived similar local angst. Its first proposed building site was opposed by UBC students living in the nextdoor residence, then by Wreck Beach supporters (a nearby nude beach); UBC finally settled on a vacant lot near the football stadium.
But citing “traditional beliefs”, residents of the luxury Promontory highrise condo building next door to the site claimed in 2011 that “living near a hospice brings bad luck to its neighbours”. As one condo owner told CTV News at the time: “Eighty per cent of the residents in this building are Asian, and 100 per cent of them are very upset!”
The condo owners’ claims were roundly discredited by prominent members of the local Chinese Canadian community in Vancouver as “a misrepresentation of Chinese culture”. The project was approved; St. John’s opened on that site in 2013.
https://www.straight.com/article-379927/vancouver/pat-carney-weighs-ubc-hospice-dispute
The negative impact on neighbourhood real estate prices is often the underlying concern of neighbours, even though this does not seem to be based on actual reality. Consider Vancouver’s Canuck Place, founded in 1995 as the first free-standing children’s hospice in North America. Its historic Glen Brae Manor site, a 16,000 sq ft mansion sits in the beautiful Shaughnessy neighbourhood (and is leased to Canuck Place for $1 per year for 50 years by the City of Vancouver). Hardly an area where any property values have gone down…
Thanks for your generous offer to use your backyard as a future Hospice site. NIMBYism is alive and well, sadly, when it comes to end-of-life care…
Thanks for your insights Carolyn. Hopefully NIMBY becomes less and less of an issue as communities realize the importance and value of hospices.
Surprising but not surprising. Surprising because it’s not a safe injection site or homeless shelter under consideration (where the NIMBYism is predictable), and because there’s nothing terribly upscale or idyllic about that neighborhood.
The absolutely ideal spot for a hospice in Toronto is the Shouldice facility. It not only has much of what’s needed already there, the grounds are beautiful. Maybe COVID will have dented the hernia tourism business enough to make it possible.
I was surprised too. I has never even remotely been a consideration here.
I would challenge that there really isn’t a bad place for a hospice. I have seen them in all types of settings and locales.
Thanks Frank.
THANK YOU. THANK YOU. THANK YOU.
You’re welcome Theresa :)
The Windsor-Essex Hospice has a stellar reputation in the community and it’s very hard to imagine that any community would be opposed to a hospice. One day they may need that end-of-life care themselves — where is the compassion?
Thanks Maureen.
You have always been and continue to be a great advocate for quality palliative and end of life care.
We will all need EOLC one day. I’m still waiting for my first patient who won’t :) But I imagine he will be a big Hollywood star playing a Marvel superhero…..
(I’m foreshadowing one of my next Healthy Debate articles. Jack will be very impressed with my literary skills)
Dear Dr. Cargill:
Thank you for your beautiful, caring, heartfelt article. I believe in everything you wrote and hope the North York residents that live in the area of the proposed Neshama Hospice, sit up and take notice.
Also thank you for taking the time to support Dr Sandy Buchman, Debbie Berlin and Rob Kamen the original founders of Neshama Hospice as well as the entire Board of the Hospice.
Most sincerely,
Rosalee Berlin RN BHSA
Thanks Rosalee.
As I point out, we are nowhere near the capacity we need for hospice beds. Hospices beds are desperately needed, especially in Toronto (who would have thought that?!). I hope Neshama is the beginning of a trend.
I am not pursuing a position with the OECD so I will be around to respond to your questions, comments and gratuitous insults.
I was CEO of Hospice Caledon when we build Bethell Hospice, a 10 bed residential hospice serving Caledon and Peel Region. If I can offer any support at any time, let me know.
Thanks Heather. Your support is greatly appreciated. I will let Dr. Buchman know.