What is a Home for the Dying (aka Comfort Care Home)?
A Home for the Dying is a home-like residence, which becomes the primary residence for individuals with a prognosis of three months or less to live. The two residents will be enrolled in hospice services prior to or upon entry to the Home. The Home also provides an extended or surrogate family — a small staff and a community of trained volunteer neighbors — to provide round-the-clock care and support to the residents and their loved ones. A guest bedroom is available for family members who wish to stay overnight in their own room.
What is hospice?
Hospice provides medical, emotional and spiritual support to terminally ill patients and their loved ones, stressing quality of life, peace, comfort and dignity, and provided by health professionals and trained volunteers. It is available to persons who no longer benefit from curative treatment and have a life expectancy of six months or less. The principle purpose is to control pain and other symptoms to help the patient remain as alert and as comfortable as possible as well as to support the patient’s family and loved ones. Hospice services are provided wherever the patient resides, in a private residence, nursing facility, or designated hospital-based hospice unit. Some hospice agencies also operate a freestanding hospice residence that allows hospice patients to receive short-term, round-the-clock care.
What is the difference between hospice and a Home for the Dying?
Hospice is not a place. It provides 24/7 on-call rather than in-person care. A Home for the Dying is not a hospice; it is a place that looks and feels like an ordinary home. Residents and their guests make use of the whole home and garden. The home setting provides a sense of everydayness. Compatible with hospice philosophy and the preferences of patients and families, Circle Home will provide “a home away from home” for hospice patients in need of a home and primary caregiver during their final months.
What is the cost?
CFD is considering the implementation of a resident fee structure for room and board for the first five years, while continuing to build a strong donor base. One bed will be charged at full rate; the second bed will be by sliding scale, based on income, and supplemented by a community scholarship fund.
How is the Home funded?
Circle of Friends for Dying does not receive any government or private insurance reimbursement. Circle Home will be financially supported by fund-raising, grants, endowments, and contributions from community members, local businesses, residents, and their families.
What are the criteria for admission to the Home?
Prospective residents will have the following:
- Diagnosis of terminal Illness: no expectation of recovery
- Prognosis of three months or less to live
- Enrollment in services with Hudson Valley Hospice (prior to or upon entry to the Home)
- Do Not Resuscitate order in place, i.e. no life sustaining measures will be done (for example: no CPR)
- No extraordinary care needs: we are unable to provide IV therapy or feeding tubes, and cannot manage difficult behaviors
- Medication needs can be administered orally, rectally, topically (patch), or by pump
- Understanding that the CFD Home is not a medical facility
- Understanding that the CFD Home is primarily staffed by trained volunteers
- Ability to be safely and comfortably managed by staff and volunteers.
With the above criteria in mind, resident selection is based on the person with the greatest need and fewest options. Admission is not determined by age, creed, color, ethnic background, sexual orientation, or religious beliefs. In order to provide care for as many people in our community who are in need, the maximum length of stay is limited to 3 months.
How are residents selected?
Prospective residents need to have a prognosis of three months or less to live and be enrolled in hospice prior to or upon admission. Preference is given to those with the greatest need and fewest options.
Why only two beds?
More than two beds in New York State is considered an institution rather than a residence. In terms of quality of care, fewer beds means a higher quality of care for residents and their loved ones.
Are there other Homes like this one?
Yes. Started in 1984 in Rochester, this model of care continues to flourish in that region and has since spread to other areas in northern New York. People prefer a Home located close to their own home (one county in Rochester has nine, nearly one in every neighborhood). As of 2018, there are 30 such Homes in New York State. CFD’s Home will be the first to open in the Mid-Hudson Valley region. Click here for a full list.
Why isn’t there a hospice residence or hospital-based hospice unit?
A study by Hudson Valley Hospice concluded that a hospice residence in Ulster County was not feasible. “Challenging times for healthcare providers increases the need for solutions like the one Circle of Friends is proposing…. Your Home would be a true alternative choice and community benefit.” ~Rich Trocino, former CEO of Hudson Valley Hospice
Will CFD be in competition with Hudson Valley Hospice for funds and volunteers?
No. Homes for the Dying share a symbiotic, mutually beneficial, relationship with their local hospice organization, working together to fulfill the needs of the communities they serve. Based on a family model, CFD volunteers can provide “hands on” care or assist with the daily upkeep and operation of the Home. The “friendly visitor” role of the hospice volunteer is more limited. Optimally, all communities benefit from an array of integrated multi-level end-of-life care settings and services to meet the varied needs and circumstances faced by terminally ill persons and their families.
How can I help CFD?
Give us a call at 845-802-0970 and get involved. All are welcome.