New Hospice Dedicated as a Model Center

Former Surgeon General C. Everett Koop came to San Diego Saturday, calling a new acute-care center for hospice patients the best of its kind in the country and the model for how the terminally ill ought to be cared for throughout the world.

Koop dedicated the center with philanthropist Joan Kroc, who said the care her father received as a hospice patient 10 years ago in Minnesota fueled her desire to provide the $18.5 million that gave San Diego such a facility.

The 24-bed San Diego Hospice Acute Care Center, not open to patients until August, was celebrated Saturday at its scenic Hillcrest setting with lavish praise from dignitaries and the release of 200 white doves into a sun-splashed sky.

The center is an extension of the San Diego Hospice program that directors say serves daily on a home-care basis more than 200 terminally patients and their families. The program has reportedly served more than a total of 8,000 patients since its inception in 1977.

Koop, who, along with Kroc, serves on the center’s national advisory board, called the 6.5-acre complex (which consists of two buildings at the foot of Third Avenue) California’s first free-standing home-care and acute-care center for hospice patients.

He lauded its potential as a “teaching unit” and as a place where the dying can meet their final days in serenity, away from the glare of a high-tech hospital.

“The thing that hospice care does away with is the very expensive intensive care that many people undergo just before they die,” Koop said in an interview after the ceremony. “One of the things that baffles many people is that the last few days of a person’s life are the most expensive days that they live.

“What hospice does is take them out of that artificial setting and put them into a homelike setting, preferably their own home, where they are surrounded by people they know, volunteers they have come to love and appreciate, and they die--I don’t talk about dignity--but with serenity.

“I don’t think we’ll get away from the institution we call hos pital , but we will begin to think of hos pice as the place where people should die and not be surrounded by machines and tubes and respirators.”

During the ceremony that featured appearances by Mayor Maureen O’Connor, several other politicians and actress Mercedes McCambridge, Koop’s voice choked with emotion as he described working with San Diego Hospice volunteers while taping a recent health special for NBC.

“They must have been burned into my soul,” Koop said. “I saw them not as figures on a television screen but as lifelong friends. The whole awful five months of production (for his ‘Forever Young’ series) was worth it just to know those wonderful people.

“What happens here can affect health-care reform in the United States, especially in these days of financial constraints and runaway health costs. But also what happens here will affect hospital care and practices and standards for this nation and for the world.”

Kroc, whose funding of the center is the largest of the many contributions she has made to a variety of causes and institutions, said that San Diego Hospice faces a big challenge financially.

“Their biggest problem will be getting support from the community, because they’re privately funded,” Kroc said. “I think and hope and have to believe that this community is sophisticated enough to support them. Ten years ago, had everything been in place, it might have been too soon.

“Now, I don’t think it is too soon. I’m delighted and thrilled. It’s a magnificent-looking, very serene complex. It meets all my expectations and more.”

The acute-care, in-patient building, which overlooks Mission Valley, features large, homey rooms with floor-to-ceiling windows, French doors leading to private patios, hardwood floors and medical equipment concealed behind wooden cabinets in case it isn’t needed.

The center is not designed for lengthy stays by any patient. Directors say the average stay will be from three to seven days, during a time when a patient’s pain or need for care has become so acute that it can’t be met at home.

True Ryndes, the center’s vice president for planning, education and research, said 80% of those treated at the complex will be cancer patients, with about 4% being AIDS patients.

Ryndes said referrals will come primarily from physicians and that private insurance companies, in paying for a patient’s care, will fund the bulk of the center’s annual operating costs of $7.7 million. He said that since 1983 Medicare also has paid for hospice care.

The Rev. Milton Hay, who has served as chaplain to San Diego Hospice for 8 1/2 years, said the best such a center can offer to a terminally ill patient is “that connection with other people.”

The isolation that such a prognosis brings “to an individual, even within their own family,” Hay said, “is almost overwhelming. The connection to a larger group, passionately caring for them, brings order to the chaos that comes, quite naturally, in our dying days. This center will be a big part of providing that connection and giving people some peace.”