By Mark Wineka
mwineka@salisburypost.com
SALISBURY — Volunteering for the hospice unit at the W.G. “Bill” Hefner VA Medical Center has become a cherished part of disabled veteran Craig Rice’s weekly routine.
He shows up at Building 42 every Wednesday, Saturday, and Sunday to befriend veterans reaching the final stages of their lives. He says the nurses and nursing assistants in the 12-room unit are phenomenal, living the mantra in capital letters over the nursing station:
“No one walks the path alone,” it says.
Rice uses the word “phenomenal” again when describing the new 12-suite hospice wing staff and patients will be moving into by next month. The new wing, connected to the end of Building 42, seems far removed from the institutional atmosphere of a typical VA hospital.
And that’s by design.
“As many places as I’ve been,” says supervising engineer John Montgomery, the VA’s manager for this project, “this has totally broken the mold.”
The roomy, private suites with private baths could pass for apartments. They have their own doorbells, and each has a patio, designed so a patient’s bed can be rolled outside where the view takes in a large fishing pond, complete with pier and paths down to the water.
Fireplaces, kennel
The inside accommodations encompass working fireplaces; family, game and meditation rooms; the Carolina Cafe dining area; a separate family kitchen; a kennel; a smart board for digital displays of family pictures; a welcome center; a family suite; and carefully tucked away offices and stations.
The facility, inside and out, looks more like a four-star resort than a hospice house.
“It will blow you away when you go through this building,” Public Affairs Officer Carol Waters promises.
The hospice wing is part of a $9.5 million, two-phase renovation and construction project at Building 42, which includes the VA’s Community Living Center.
Construction on the first phase started in November 2010. Besides the hospice wing, the construction includes a reconfiguration of Building 42’s skylit atrium, transforming it into a Main Street.
Along this Main Street are a store, theater, barber, “town hall” meeting room, wellness center, a pottery shop, offices for recreation therapists and street kiosks for vendors — all meant for the veteran patients in short-term rehabilitation, long-term maintenance, respite care and palliative and hospice care.
The Main Street backdrop includes new plants, furniture and railings to go with the old atrium’s waterfall, ponds and decks.
“I think it’s outstanding,” says Frank Burns, a hospice patient. “I can’t wait for it to open. This is something that is so needed here.”
Six-room ‘Hoptel’
The project also includes a $1.5 million renovation in the basement of Building 42 to create a six-room “Hoptel.” The Hoptel will be used by out-of-town veterans receiving healthcare services at the VA. They might need to stay overnight because they have early outpatient procedures scheduled the next morning.
Or, as another example, patients receiving chemotherapy treatments at the VA might need to stay at the Hoptel overnight before they feel up to heading home the next day. The Hoptel rooms are designed for veterans who can take care of themselves.
Together, phases 1 and 2 of the construction at Building 42 — Phase 3 has yet to be bid— will renovate 45,244 square feet of existing space and add 18,459 square feet in new construction.
The VA hospice, created as a separate entity in September 2009, has an average daily census of nine veterans. This week, there were six patients in VA hospice care. Generally, in-patient admission priority is given to veterans with a life expectancy of two to four weeks and can extend to three months or less.
Renewed life
Frank Burns, like the new hospice wing, fortunately breaks the mold of the typical hospice patient.
A career Air Force man, Burns has prostate cancer. He wasn’t expected to live to Christmas last year. When he survived the holidays, the VA in Durham sent him to the hospice unit in Salisbury, where again his oncologist didn’t think he would make it 10 days.
But Burns swears the care he has received from the hospice staff here has prolonged his life. Though wheelchair bound, he has gained 30 pounds, and his breathing has improved considerably.
“I felt a renewed life, I really did,” Burns says, describing hospice nurses as a breed to themselves.
Burns looks forward to the new wing and playing a role in making Semper Fi, a hospice therapy dog, feel at home. (See the accompanying column.)
More like home
The hospice staff includes a program coordinator, nurse manager, medical director, chaplain, eight nurses and five nursing assistants.
Lynne Mullis, a nurse, said the “nurse nooks” in the hospice wing are tucked around the corners opposite from patient suites, so they are out of view, yet convenient.
“The nurse nook puts us behind a wall,” she says.
Likewise, the offices for Coordinator Marilyn Warlick, Nurse Manager Dana Moose and others will be behind the scenes, along with an employee break room. Every measure has been taken to create a residential feel as much as possible.
Handrails blend in well with the wall paneling. Cabinet doors in the patients’ suites hide necessary elements such as oxygen hookups.
Each room has lifting apparatus on a track, which runs from the bedroom to the bathroom, making it easier to get residents out of bed or off the toilet, for example.
The meditation room has a cathedral ceiling and a church-like feel. Its expansive windows look onto the pond.
Beyond the pond, the hospice residents will be able to see a portion of the Salisbury National Cemetery and its neatly aligned white markers.
Veterans’ input
Waters, the public affairs officer, says the VA conducted focus groups with veterans and asked their input on whether views of the National Cemetery are appropriate for VA patients and, especially, the veterans in hospice care.
Most veterans answered that they found great comfort in being able to see the cemetery, Waters says.
Hallways in the new hospice wing have names such as Liberty Lane, Patriot’s Path and Freedom Way.
When a veteran dies in the hospice unit, his bed is draped with the American flag, and red and white roses are placed outside his door. The room stays empty for 48 hours to allow for a time of remembrance.
The unit, whose staff members often become emotionally attached to the hospice residents, also hold remembrance ceremonies a couple of times a year to help reconnect with the families of lost veterans.
Mullis says the Salisbury hospice unit has earned the highest ratings in bereaved family surveys among the eight VA hospitals in its region, which takes in four medical centers in North Carolina, three in Virginia and one in West Virginia.
“It’s a beautiful building,” Mullis says, walking around the new wing, “but it’s a beautiful staff, too.”
Rice, the Army veteran who volunteers at the VA hospice, couldn’t agree more.
“They give such attention to these fellas,” Rice says. “They’re as good as the patients themselves. They’re in the rooms consistently, right there with whatever they need.”
Rice says the VA hospice unit tries to make the veterans as comfortable as possible “for the balance of their journey.”
“When you can instill peace and comfort and give them assurance that God has them in his hands,” Rice adds, “that’s a big thing.”
Contact Mark Wineka at 704-797-4263.