What do people want as they near the end of their lives? Surveys consistently show that the vast majority
don’t want to spend their final days in a noisy, sterile-looking hospital room, hooked up to ventilators, tethered to IVs
and feeding tubes. They’d rather
die at home, surrounded by family and friends. They want to
live out their final days in comfort, free of pain. But most
people at the end of life will not experience a gentle landing.
Only 20
percent die at home. The rest end up in hospitals, nursing
homes, and other institutions. More people than ever before
spend their final hours often incoherent, kept alive by machines
and medical interventions—many experiencing unwanted pain
and suffering. Increasing numbers of people are dying in
pain—61 percent in 2010, a 12 percent increase from
1998.
There is a way to address pain and suffering—it’s
called palliative care—healing and comfort care for people
who are nearing death or facing a serious, life-threatening
illness. But despite all the advances we’ve made in modern
medicine, palliative care is not universally available for
everyone nearing the end of life.
Zen Hospice and the Benefits of Palliative Care
The hospice movement was the first to provide palliative
services for the terminally ill on a widespread basis. It was
started by Cicely Saunders in England in the late
1960s. Saunders established St. Christopher’s Hospice, the
first hospice to use pain and symptom control, compassionate
care, and palliative care for patients near death. In the early
1980s, the hospice movement spread to the United
Luca Singer, Zen Hospice Project resident
States. The Zen Hospice Project in San Francisco was one of the city’s first residential
hospices that started during the AIDS crisis. Zen Hospice is
housed in an old Victorian and space is limited—it can
only accommodate six residents at any one time. Luca Singer was
one of the lucky people who spent his final days at the hospice.
It took several months for Luca to be admitted. By then, Luca
was in excruciating pain. “My brain is constantly
swelling,” said Luca, “I have a tumor behind my
right eye—five brain surgeries, terminal brain cancer.
Sometimes, it’s so painful, I puke.” In addition to
the brain cancer, Luca got hit by a car and broke both his legs,
his hip, arm, and shoulder.
When I met Luca in the spring of 2016, he was resting
comfortably in a bright, sun-filled room that overlooked a quiet
tree-lined street. Luca called this place “a healing
sanctuary.” His pain was mostly under control and his
depression is not as acute, thanks to the palliative care team
at Zen Hospice. The medical staff treated his physical pain with
medication and hospice volunteers, spiritual counselors, and
social workers helped lift his spirits.
George Keller, Executive Director,
Zen Hospice Project
George Keller, executive director of Zen Hospice, says the
goal is to address the needs of the whole person, with the aim
of maximizing his comfort. “We’re trying to make it
possible for people to live more fully until they die,”
said Keller, “What we do is make an attempt to be present
with the person. ‘May I touch you? Would you like me to
hold your hand? Are your feet warm?’ Or just be quiet that
unfolds into a communication.”
Good food is an important source of comfort for many people.
The kitchen is at the heart of Zen Hospice—warm, freshly
baked cookies and pastries for staff and volunteers and home-cooked meals specially prepared for each resident. It’s
definitely not the bland food many of us
Priscilla Callos, Zen Hospice Project Chef
associate with
hospitals. Before his illness, Luca worked as a chef and he gave
Zen Hospice his highest rating—“gourmet” was
the way he described his meals. “I feel like royalty and I
feel spoiled the moment I wake to the moment I go to
sleep,” said Luca, “I couldn’t be in a better
place. It’s a dream come true. Everything I wanted,
needed, and desired is being met.”
A few months after we spoke, Luca passed away peacefully in
his sleep.
