Coming Home Hospice
AIDS Patients are Few, Quality Care is Outstanding

by Ken Ludden for the San Francisco Spectrum

Coming Home Hospice opened its doors in 1987, with 15 beds for terminally ill patients. With 10 beds dedicated specifically to AIDS patients, it was the major San Francisco hospice for AIDS. But as more sophisticated drug treatments became available and people began to live longer with AIDS, the number of beds providing hospice care for AIDS dwindled. Richard Nasca, Director of the hospice, said 1995 was about the year the staff started to notice a difference. “We don’t have any right now” Nasca says, “we usually have one or two. Last month we lost three.”

But the shrinking number of AIDS cases has changed little. “I don’t think the atmosphere changed,” he says, “because it has always been very loving, positive and supportive place. Who was here, and what was the diagnosis, was relatively unimportant. With palliative care we focus on making it comfortable for the patient and their family.” And it is those family members who make up part of the current staff. “What I have seen happen in a short period of time with families and patients and staff is nothing short of awesome. The staff is intimately involved with as many families as choose to be here. The family members often become volunteers here. Some, over the years, have begun working here.”

Hospice care is, or palliative care, is for the very end of life. In the beginning, when many people were shunning family and friends who developed AIDS, it was a true haven of good will. “The first day I walked into this place,” Nasca recalls, “the love and support and closeness and good positive feeling was palpable. You can feel it. It just engulfs people who come in here. You are welcome; you are loved.” In the early days, people with AIDS, having no place to go, needed the love more than ever. And that love had a healing power, even for the terminally ill, and certainly for their friends.

Today, the length of stay for AIDS patients fluctuates. “Most people would prefer to stay home if they can and have enough support to basically take care of them. Where we play an important role is when there is no longer someone who can safely take care of them, so there’s always been that percentage. In my observation, people will stay home as long as they can, and that means by the time they need full hospice inpatient care, or at a facility as this, they are not here as long because if they are not safe and able to be taken care of at home they are usually in the final stages. They are not here very long.”

The legacy of AIDS, here, has been a positive and lasting one. Coming Home Hospice developed close ties with the LGBT community, and remain quite active in that community. “We’ve been involved in fundraisers,” he says, “we took an active part in the Pride Parade, and we always have people in that. So it’s always been very well connected to the gay community.”

With residents coming from all over the Bay Area, lingering relationships with family members beyond the loss of their loved one, and strong ties to the LGBT community, Nasca hopes the good name of the Coming Home Hospice will engender support. “Because of our structure we are heavily supported by donations and foundations,” says Nasca. “We continue to be actively involved in that. We are a program of the California Pacific Medical Center (CPMC) and much of the funding comes from the foundation. Still, money is always a concern.” A current concern is the constant need for sheets and pillow cases. “I just got a call from someone who was with the Castro Alliance and we’ve been talking about a constant need for linen supplies and we are looking into putting together a program for linens.”

Nasca has as much gratitude for the LGBT community, as members of it are forever indebted to Coming Home Hospice. “I want them to know we’re here to support the community; we are always open to being part of it. If there are people who could use our services, we are always in desperate need of support funds. We have always run at a deficit, a very large one. We’re always looking for ways to offset that. We depend on the foundation but we are always looking for the kindness of the community.”

For those in need, and for those who would like to donate funds or linen supplies, Coming Home Hospice can be found on the internet through links at www.cpmc.org. On that site there’s a listing for the Visiting Nurses and Hospice, and from there you can click on Coming Home Hospice.

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