Lions Gate Hospital and the recently opened North Shore Hospice are a short walk and a world apart.
The hospital is big, bright and bustling. The hospice - which is a component of Lions Gate's palliative care program and compliments its palliative care unit - is a single-storey building on a cul-de-sac.
The contrasts continue inside, where the focal point of the hospice is a great room with easy chairs and a fireplace. Light floods in through oversized windows.
Patient rooms - there are only 15 of them - are large, with pullout couches for visitors and big windows built low to the ground to ensure that people lying in bed can see out of them. Rooms have been designed with angled walls, a touch that makes them feel less institutional.
The hospice, which took in its first patients in November, reflects the co-ordinated efforts of Vancouver Coastal Health along with the Lions Gate Hospital Foundation, Family Services of the North Shore and Lions Gate Hospice Society. Vancouver Coastal - which oversees Lions Gate - donated the site for the hospice and runs the facility. The foundation and its partners raised $8.5-million to build it.
The building also reflects growing societal recognition of the needs of dying people and their families. "The community support has been overwhelming," says hospice manager Jane Webley. "We ask and somebody gives."
Numerous items, from furniture to artwork, have plaques with donors' names on them, the facility owing its existence largely to individuals, service groups and businesses that dug into their pockets for its construction. There are also many donated items that don't bear any label, such as computers - with wireless keyboards that patients can use in their beds - and the hundreds of DVDs that stock an entertainment room.
The millwork in a room set aside for spiritual reflection was donated. A community group raised $35,000 to buy a hydrotherapy, lift-equipped tub.
The facility is meant to be inclusive. Representatives from nearly a dozen faith groups attended a blessing ceremony for the sacred space, which is neutrally furnished and decorated.
Outside, a garden is taking shape, with a paved walkway designed to be accessible for someone in a wheelchair.
There are lounges for family gatherings, such as a recent birthday party for a young girl whose mother was dying of cancer.
For Joan Brown and her family, the hospice feels something like home. Ms. Brown, who entered the hospice in early December, says she's relieved to be there. Her children have struggled to support her as her health failed, she says, adding that hospice staff are "very kind."
Her son, Robin Draper, praises the staff and says the hospice provides support - such as meals and bathing - while making it possible for families to do small tasks, whether fetching an extra blanket or making a cup of tea.
"You feel like you can do things without infringing on the staff," Mr. Draper says.
There are hospices throughout B.C. and Canada, but not all communities are equally or even well-served. At least 70 per cent of Canadians do not have ready access to palliative care, says the Canadian Hospice Palliative Care Association, and demand for such services is expected to grow as the population ages.
Palliative hospice care is considered as much a mindset as a physical reality, in that it focuses not on "curing" someone but on providing care that can make that person's remaining days, weeks and months more comfortable and meaningful.
With more than a decade of experience in the hospice field, Ms. Webley says she often sees a sense of calm in patients and their families - and occasions for joy and celebration - once patients have moved into a hospice. Simple things, like shower facilities provided for family members who are staying with a loved one around the clock, can make a tough time more bearable.
At the North Shore hospice, the average stay is around a month.
In January, the hospice will begin its planned day program, the first of its kind in Western Canada, that will give users access to hospice services - such as bathing or foot-care - and respite to caregivers.
"People can be a mom, a daughter, a son, a father," Ms. Webley says. "They can focus on what's really important."
North shore hospice
What it is
The first freestanding hospice - providing end-of-life care - on the North Shore. The 15,000-square-foot facility contains 15 rooms and a host of amenities, including special bathing facilities, a wood-paneled sacred space that looks out to a garden and an in-house kitchen that provides meals to patients and visitors.
Why It Works
It bridges the divide between two competing realities - most people who are terminally ill want to die at home and, in many cases, families and caregivers can't provide the care those dying people need.
Bangladesh Health Project update
The Bangladesh Health Project, launched in 2003 by members of Vancouver's Mid-Main Community Health Centre, is designed to strengthen nursing education and practices in Bangladesh, where the profession suffers from a lack of standardized training.
Nurses in the country - one of the poorest and most densely populated in the world - are typically poorly trained and underpaid, and hospitals that can afford to tend to hire from outside the country. Working with Dhaka's International University of Business Agriculture and Technology, volunteers with the Bangladesh Health Project provide a bachelor of science program in nursing.
Instruction is in English. The program turned out its first graduates - there have been about a dozen so far - in 2009. Some of them have gone on to work in training or leadership roles in the country's hospitals. As well as working with new students, volunteers want to educate a core group of Bangladeshi trainers so that the program can be self-sustaining.