Bobbys Hope House

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• Bobbys Hope House
• Our Future Residential Hospice

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A Residential HospicePalliative Care in the
Community

• Small, not institutional
• Home Away From Home
• Maximum of 10 private bedrooms
• 24 hour access for family
• 24 hour nursing/medical care
• Supported by volunteers
• Pain symptom mgt. and psychosocial/spiritual
  support that relieves suffering encourages
  communication, fosters hope prepares people for
  loss

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DEATH Todays Reality

• 80 die of a chronic illness (palliative
  diagnosis)
• 20 die an acute death

In Greater Saint John 1,000 deaths / year
800 are palliative
In Region 2 1,500 deaths / year 1,000 are
palliative
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Death Reality in 20 years

• Seniors account for 75 of annual deaths
• By the year 2025, the proportion of seniors in NB
  is projected to be 21 higher than the national
  average.
• Of New Brunswicks three major centres, Saint
  John is the oldest. - Telegraph Journal, July
  18th
• Projections for Greater Saint John
• 2000 deaths/year
• 1600 palliative deaths
• 400 acute deaths

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Where do People Die?

• Most want to die at home breakdown in last
  weeks/months of life when 24-hour care needed
• Most in fact die in institutions 90
• (75 die in hospital, 15 in NH )
• Saint John Regional Hospital
• PCU annual palliative deaths 200
• Other beds annual palliative deaths 200
• 50 of the areas identified annual palliative
  deaths occur in one Hospital

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Palliative Patients in Acute Care Beds Outside
of the PCU

• Inappropriate level of care
• Expensive
• Affects access to acute care beds
• Not as holistic as the care offered in a Hospice
  setting

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CHPCA Norms of Practice

• Hospice Palliative Care is a set of services
  offered in four settings
• Home
• Hospital
• Nursing Homes
• RESIDENTIAL HOSPICES

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Residential Hospice

• Provides timely access to comprehensive hospice
  palliative care services
• Right care at the right time by the right
  providers
• Setting of Choice - non-institutional care a
  home away from home

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Residential Hospice

• Frees Up Acute Care Beds
• ALOS for palliative patient in acute care bed is
  22 days in comparison to 5-10 days for acute care
  patients
• Using the same bed for acute care services will
  reduce wait times for elective surgery and
  admissions from the ER

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Residential Hospice

• Allows More Healthcare Dollars to be Used for
  Acute Care Services
• Cost of Residential Hospice is 300/day.
• Cost of Acute Care Hospital Beds is 1,000 per
  day.
• Residential Hospice is cost-effective care.

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Residential Hospice

• Supports economic development and contributes to
  self-sufficiency
• A timely and accessible acute healthcare system
  is needed to attract and keep workers

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• Governments Healthcare Priorities
• 1. Increasing Access
• 2. Reducing Wait times
• 3. Cost containment
• 4. Sustainability
• Government Business Priorities
• Economic Development Growth
• Self-Sufficiency
• Residential Hospice is part of the solution!

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Win-Win-Win-Win-Win-Win

• Government - Right Care (Access), Right Time
  (Wait Times), Right Providers (Sustainability,
  Cost Containment and Self-Sufficiency)
• Business Supports economic development growth
• Hospital Increased access to acute care beds
• Patients Setting of Choice (non-institutional)
• Families - Support when needed
• Hospice Deliver on our Mission Vision

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Residential Hospice Capital Costs

• St. Josephs Convent valued at 1.66 million to
  build at todays costs
• Sisters of Charity elected to invest in the
  establishment of a Residential Hospice for our
  community and NB sold Hospice the property for
  250,000
• Would have cost over
• 1 million to build

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• Living Room

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• Living Room

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• Quiet Room

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• Quiet room

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• Volunteer Reception

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• Dr. Nancy Grant Library

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• Sisters of Charity Chapel

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• Divine Divas Dining Room

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• Friends of Hospice Kitchen

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Future Residential Hospice Bedroom
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Future Residential Hospice Bedroom
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Future Residential Hospice Bedroom
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Future Garden of Hope Healing
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Future Garden of Hope Healing
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Realize the Dream Capital Campaign 2007 - 2010

• Hospice to fundraise 1 million over 2 years to
  renovate and ready for operations in 2010
• Code Renovation Costs 645,600
• Supplies/Equipment/Garden 150,000
• 1st Year of Operations 200,000
• Government, Foundations, Corporate, Service
  Clubs and Individuals

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Code Renovation Costs

• Elevator 75,000
• Architectural Improvements 150,000
• Sprinkler System 50,000
• Plumbing Upgrades 75,000
• Ventilation Upgrades 128,000
• Electrical Improvements 60,000
• 20 Contingency 107,600
• Total 645,600

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Residential HospiceAnnual Operations - 840,000

• Expenses
• 0.20 FTE Medical Director 40,000
• 1 FTE Resident Care Manager 69,000
• RNs, LPNs, PSWs 666,000
• 1 FTE Housekeeper/Cook 25,000
• Supplies, Food 35,000
• Revenue
• Provincial Government 580,000
• Hospice 260,000

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Nursing Coverage

• Nursing Care 1 Nurse Manager
• Day Shift 1 RN
• 1 LPN
• 1 PSW
• Evening Shift 1 RN
• 1 LPN
• Night Shift 1 RN
• 1 PSW

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Physician Coverage

• People admitted under the care of their family
  physician responsible for 24-hour medical
  coverage
• FP has access to 0.20 FTE Hospice Medical
  Director for consultation, support and overseeing
  care

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The Request to NB Government

• 1. Make Residential Hospice part of NBs
  innovative healthcare and seniors plans due in
  Fall 2007
• Put Residential Hospice operational funding -
  580,000/year - in the 2010 NB Healthcare Budget.
• Provide some capital funding to support space
  renovations (RDC, ACOA CMHC).

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Current Status

• NB Political Agreement Shawn Graham, Mike
  Murphy, Roly MacIntyre, Mary Schryer, Ed Doherty,
  Jeannot Volpe, Trevor Holder
• Federal Political Agreement -Tony Clement, Greg
  Thompson and Paul Zed
• Community Leadership Agreement
• Greater Saint John Mayors
• AHSC Board of Directors
• Saint John Board of Trade
• Sisters of Charity
• Saint John City Council

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Everyone Says Yes!
Residential Hospice Helping People Live With
Dignity, Comfort and Peace
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Residential Hospice

• Projected Opening
• Spring 2010

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• At some time, in some way, we must
• all face the end of life.
• And most us share a common hopethat when death
  comes to us or to a loved one,
• it will be peaceful and free of pain.
• We hope to face death surrounded by a circle of
  support, feeling safe, comfortable and cared for.
  
• This is the promise of Hospice
• Greater Saint John.