By Patrick Downes

St. Francis Healthcare System of Hawaii is planning a new 24-bed freestanding hospice in east Oahu.

To be called St. Francis Hospice East, the facility is part of St. Francis’ move away from acute hospital care toward long-term services for the elderly, sick and dying.

“As part of our transition plan, we’ve decided to focus on our long-time center

The St. Francis Hospice Program Brief history St. Francis Healthcare System introduced hospice care to Hawaii in 1978 as a service in the patient’s own home or hospital. In 1988, it opened Hawaii’s first freestanding hospice, the 12-bed Sister Maureen Keleher Hospice Center in Nuuanu. It opened its second freestanding facility in 1997, the 24-bed Maurice J. Sullivan Family Hospice Center in West Oahu. St. Francis hospice centers and services are the only ones in Hawaii accredited by the national Joint Commission on Accreditation of Healthcare Organizations. Questions and answers about St. Francis Hospice care Q. Who can receive hospice care? A. St. Francis Hospice is designed for those expected to live six months or less, though care can be extended beyond that period depending on the course of the terminal illness. Q. Are there any restrictions on the type of illness? A. No. Q. How about the ability to pay? A. Patients are accepted regardless of race, color, national origin, religion, disability, age, or ability to pay. Q. Is the purpose of hospice to prolong life? A. No. Hospice exists to make the dying process as comfortable as possible for the patient, and for family and friends. Q. What services are offered by St. Francis Hospice? A. St. Francis Hospice offers 24-hour assistance delivered by a team of professionals in a patient’s home or at one of its freestanding facilities. Here are the usual services: -- skilled nursing -- counseling by a licensed social worker and links to community services -- nutritional services including counseling by a registered dietician -- spiritual care by a certified pastoral counselor consistent with the patient’s beliefs -- bereavement support by a licensed social worker to as many survivors as possible -- volunteers who enhance the quality of care and supplement the professional staff A. At-home hospice patients are usually cared for by family members or caregivers with St. Francis team members making regular visits. A nurse and physician are always available to provide advice over the phone and, when necessary, to make visits. Q. What are the bereavement services? A. St. Francis Hospice bereavement services provide psychosocial and emotional support for survivors throughout all phases of hospice care and through the first year following death. Survivors are free to choose how they will participate. Activities include: -- support groups at both hospice facilities -- “Lunch Bunch” groups in both facilities -- “Walk in the Mall” programs at Pearlridge and Kahala Mall -- grief classes at the Sullivan facility -- annual family potluck picnic -- annual interdenominational memorial service at Nuuanu -- Christmas tree lighting events at both facilities St. Francis also hosts community educational seminars on grief and coping skills.

of excellence,” said Eugene Tiwanak, president of St. Francis Healthcare Foundation, “and that is hospice.”

St. Francis was the pioneer in Hawaii in hospice care, the service that provides dying patients with comfort, spiritual and psychological care, and offers bereavement support for family and friends.

It has two centers, Nuuanu and Ewa, but they are not meeting the growing need for hospice in Hawaii.

Tiwanak said it is “terrible” the choices families must face today when hospice is not available.

For many patients, there is only so much you can do at home, so they have to stay in the hospital to die there, he said.

“That creates a financial burden and an emotional burden, and the family doesn’t know what to do,” he said. “The real services of hospice are the counseling that comes along with it — financial counseling, spiritual counseling, social servicing. They’re absent in the hospital environment.”

“It’s terrible,” he repeated.

The cost for a hospice bed is $240 per day while the cost for an acute care hospital bed is $880.

St. Francis has been feeling the demand to build another hospice for some time now.

“We’ve been studying it for the past three years,” Tiwanak said. All arrows point to east Oahu as the place where the need is greatest.

St. Francis’ Nuuanu hospice is now bearing the bulk of the Honolulu, Windward Oahu and East Oahu need. An east Honolulu facility will go a long way in easing that burden.

“The whole idea is to make it accessible and available to the people,” he said.

St. Francis is looking for a site between Kahala and Hawaii Kai and has developed preliminary renderings to show the community and potential benefactors.

The drawings show an extensive one-level facility with plenty of landscaping and open spaces.

“We’ve been the business 30 years so we have learned a lot” about how to design a hospice, Tiwanak said.

Meditation courtyards and mini-gardens will be part of the new plan. And, of course, art. The facility will be home-like and family-friendly. The rooms will allow family members to spend the night and remain with their loved ones in their final days.

The total projected cost for property development and construction is $12 million. The St. Francis Board of Directors and Franciscan Sisters have already pledged $2 million. The Jack and Marie Lord Fund is expected to provide more than $300,000 annually in perpetuity.

St. Francis plans to announce the location early next year, begin construction soon after and dedicate it in 2008.

99-100 percent occupancy

Since its founding in 1978, the St. Francis hospice program has served more than 13,000 patients, both at home and at its two in-patient facilities. The Sister Maureen Keleher Center in Nuuanu has assisted more than 2,200 patients and the Maurice J. Sullivan Family Hospice Center in Ewa more than 3,000.

Cancer patients make up 62 percent of those admitted. The remaining 38 percent have Alzheimer’s, end stage heart disease, dementia, liver disease and other illnesses.

This year, the average length of stay in a hospice facility is 42 days, with approximately 37 deaths per month.

The two free-standing facilities are always full, running at 99-100 percent occupancy.

About 55 patients are put on a waiting list each month. A little less than half of them are able to receive home care services, while the rest must remain in a hospital. About 18 of those patients — 216 a year — never get a bed.

According to St. Francis, the demand on Oahu for hospice increases 15-20 percent every year.

And knowledge that St. Francis has a waiting list probably accounts for many more qualified patients not applying, Tiwanak said.