Hospice of the Western Reserve

At the corner of East 185 Street and Lakeshore Boulevard you will find the Hospice of the Western Reserve (HWR), nestled along the lake. So what, exactly is a hospice? If you’re like me you may think of this as a dingy ward, some place where gray and shaky old people wheeze out their dying breaths. Utterly depressing. Turns out that is a grave distortion of reality - a huge misunderstanding. The building you can see is but the tip of a much larger iceberg. True, the building we’re discussing houses 42 terminally ill patients but the vast majority of the six thousand odd clients of  HWR live at home or in assisted living. Though most hospice patients are physically weak, this is by no means a place of gloom and misery. A hospice can actually be a very happy environment.

Nan and I visited the hospice last week and were shown around by John Harvon. What a wonderful place it is! Art adorns all the walls and it is such warm and friendly art – all made by patients and their families. And everywhere the design is so clever, they really have thought of everything. For instance there are no overhead lights in the passages; why? Because patients frequently come on gurneys and don’t want to be dazzled. All the rooms have patio doors that open onto a delightful garden. And there are public spaces for gatherings with whimsical clouds decorating the atrium ceilings. There is a nicely equipped playroom for visiting children. Kitchens and sitting rooms are also available for visiting family and volunteers, and family can even sleep over in patients’ rooms. Beautiful gardens that are open to the public are lined with donor memorial bricks and provide enchanting lakeside views extending to embrace a downtown vista. There is even a smoking room since they wisely take the view that it is too late and too unkind to try to break the terminally ill of bad habits.

HWR is in the business of providing palliative care. So what, exactly is “palliative care"?

Wikipedia describes it thus (emphasis is mine): “Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than  --- provide a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness.” It goes on to say: “Although the concept of palliative care is not new, most physicians have traditionally concentrated on trying to cure patients. Treatments for the alleviation of symptoms were viewed as hazardous and seen as inviting addiction and other unwanted side effects ---The focus on a patient's quality of life has increased greatly during the past twenty years. In the United States today, 55% of hospitals with more than 100 beds offer a palliative-care program. --- hospice services and palliative care programs share similar goals of providing symptom relief and pain management.”

So, given this much extended role, you won’t be surprised learn that Hospice of the Western Reserve has as many as 869 employees, 1200 volunteers and ten full-time doctors in 9 locations through a half-dozen counties in Northeast Ohio. HWR spends about $82 million each year on patient care. $4 million comes from annual fund-raising drives, about $20 million from endowment funds and the rest from Medicare (85%) and Medicaid (5%), with most of the remaining 10% coming from commercial insurers. If you’ve looked at the cost of extended care insurance recently you’ll be truly staggered by the efficiency of HWR who turn the $140 daily allowance they receive from Mediacare into such a thorough and all-embracing system of care. And it’s top quality care. The employees have the wide variety of skills required – nurses with many specializations, social workers, art therapists and spiritual counsellors. The volunteers also provide a wide range of services: pet therapy, office assistance, music, boat outings, spiritual support and companionship and even lawn mowing. Before year-end HWR will break ground for a new facility on the West side of Cleveland.

The service provided by HWR is available to anyone who has been diagnosed with a fatal medical condition. And these services are extensive. For most clients membership and all the services this provides are absolutely free because they are entirely covered by Medicare or the person’s health insurance. The only paying clients are usually tragically young – even children.. Members living at home receive weekly visits from a nurse and a social worker and needed drugs are delivered free. Services don’t terminate with the patient’s death as HWR continues to provide bereavement counselling to family and loved ones.

Way back in the days of Chaucer there were hospices, but they were boarding houses for pilgrims travelling to holy sites. A famous surviving hospice of that type is the Saint Bernard facility in the Alps. Hospices as we  know them today originated in England in the nineteen sixties. The movement spread to the US with the first American hospice opening its doors in 1974. HWR is one of the oldest hospices in the US, and was founded originally in Lake County four years later in 1978.

Recently HWR acquired The Christian Life Center from the Cleveland archdiocese. The building will be demolished scrupulously so as to salvage as much of its material as is possible. It will then provide a beautiful lakefront garden for spiritual refreshment.

For any of you who are keen linguists, the word hospice is rather intriguing. It derives from the latin hospitum, meaning a place of rest. It first entered the English language around the time of Chaucer (fourteenth century) as the word hostel, meaning a boarding house for students. At about the same time the word hospice was taken up, as mentioned above, as the word for pilgrim boarding houses. Later it reentered the English language as hospital, a place for treating the sick and injured. Then, when Cesar Ritz invented the modern luxury hotel in the nineteenth century, the French word hotel entered the language. And finally, as we’ve been discussing, the hospice acquired its modern meaning some fifty years ago. Incidentally, the word host derives from the latin word hospes from which hospitum derived.