It was about 15 years ago, but Gay Klietzke still vividly remembers the first person she saw through to death as a hospice volunteer in Kamloops.
"There was sadness, but we felt we had done the best we could. We had made the death as peaceful as possible," says Ms. Klietzke, now executive director of the Vancouver Hospice Society.
"It was really humbling and a privilege to be there."
Ms. Klietzke, 60, is now doing her best to see through a fundraising drive to open a new freestanding hospice in the city's west side by the end of 2011.
But Ms. Klietzke, who worked in her family's appliance business before devoting herself to the hospice movement, has One Big Idea: four or five small hospices around Vancouver over the next decade, each with six beds. The overall cost to build and operate for the first three years would be about $20-million, raised through donations.
What do people say to you when you mention your work?
They say to me, 'That's very sad. Aren't you unhappy all the time?' or, 'It must be awful to see people die.' And I say no. I say a hospice home is quite a happy place. Sad things happen in a hospice. People die. But it's a very happy place. We are talking about living until you die. We are not talking about dying. You can have a lifetime in two weeks. We make a hospice home just like a home, supporting the families. The patient can eat ice cream at midnight if they want to.
Why is it better to die in a hospice than a hospital or at home?
If you talk to any Canadian, they will say if they had their wish of where they wanted to die, it would be at home, obviously, surrounded by their family. We support that. But if, at the end, they cannot do that, we are providing a home away from home. But there will be medical people who can care for their pain and symptom management. We will be there to support the family as well.
Why do we need four or five more hospice homes in the Vancouver area?
First of all, we are not talking of four or five large facilities. The Vancouver Hospice Society's vision is to build community-based, smaller home-like hospices over a period of time. This would amount to approximately 30 new beds. We have all heard of the aging crisis that will soon be upon us; by 2026, approximately 20 per cent of the population will be over 65 and about 80 per cent [of people in that age group]have [at least]one chronic disease. And of those, about 70 per cent suffer from two or more chronic diseases - chronic diseases account for 70 per cent of all deaths.
Certainly these kinds of numbers are going to tax our health system.
Hospice homes not only provide beds for people who are at the end of their lives, we also provide support for those who wish to die at home. This support could be offered in the way of respite beds so that the patient could come into the hospice home for a few weeks to give their caregivers a break and then go back home again. We also offer a home hospice volunteer support program, where we place volunteers in the home to also give caregivers a break. In addition to this we provide support for family and friends that are affected by a loved one's approaching or recent death.
What kind of reception are you finding from various levels of government?
We're not really involved with the government that much. Vancouver Hospice was well aware when they took on this project that there would be no funding from the government. That's why we built in our fundraising budget the three years of operating funds, because we felt that would be fiscally responsible.
We certainly talk to the health authority. They know what we're doing and certainly they have licence requirements we're holding up to. We work with them on a referral program for our home hospice program. There's nothing adversarial about it. We recognize there is no money at the moment for us.
What kind of frames of mind do you see when patients come into the hospice?
We see them come in very frightened because the word hospice may mean they come in and never go out again. Many times, I see them relieved because they have made up their mind there is going to be no more treatment, and whatever time they have left, they are going to live it the way they want, and we'll take that journey with them as they go towards their end. And I have seen people come in to hospice who have walked in on their own. You wonder, 'My Goodness. He looks quite well.' And the next thing, they get in there and they take to their bed and they die. Sometimes it's just a relief off their shoulders that their family doesn't have to care for them any more.
What have you learned from your work that would help you when you face death?
Not to be frightened, and know there is something beyond this life. I truly believe that. I believe there is a spiritual life beyond this and so not to be frightened. What it has done for me, this whole movement, has made me live every day of this life well, to tell people I love them, to live as if it's my last day because we never know what's going to happen. People in the hospice movement are well aware of their own mortality, and so that's changed me completely.
This interview has been edited and condensed.