Caring with touch of home Hospice: The Gilchrist Center, the area's first free-standing inpatient facility built as a hospice, offers a choice for "acute' and "residence" patients.

September 19, 1996|By M. William Salganik | M. William Salganik,SUN STAFF

Styled with "an English country manor" exterior and a homey interior, the Gilchrist Center, an inpatient hospice facility, will be dedicated today on the campus of Greater Baltimore Medical Center.

As the first free-standing inpatient facility built as a hospice in the Baltimore area, it is something new, but it is also part of a trend, as demand for inpatient hospice beds is growing nationally and in the region.

Gilchrist Center is a project of Hospice of Baltimore, which also provides home hospice care for about 80 patients. Hospice of Baltimore is part of GBMC Health Care, the parent of GBMC.

Designed as a hospice, the center contains amenities for terminally ill patients and their families: double doors from each room opening onto gardens or balconies, cabinets that discreetly enclose medical equipment, skylighted sitting rooms, lounges where visitors can sleep at night, a kitchen and dining room for the use of families.

"If I had designed it, I couldn't have done much better," said Sylvia Rosenfeld, of Randallstown, now in her fifth week as a patient there. (Although the dedication is today, Gilchrist Center accepted its first patients in July.)

For example, she said, when her grandchildren visit from Pennsylvania, they can spend some time in a children's playroom. Her husband, Sidney, enjoys taking her to the garden during his daily visits. And, even more than the facilities, she praises "the service, the attention. Everything is so fast -- you never wait for anything."

"This place is fantastic," says Sidney Rosenfeld. "It give people a chance to live, not to die."

The facility is designed to meet the needs of two types of patients, said Carol Peltier, president of Hospice of Baltimore: "acute" patients who need "symptom management," but not necessarily the level of care of a hospital, and "residence" patients who "for one reason or another do not want to stay at home" in the final stages of illness.

Although the preponderance of hospice care is still given at home, "there is a trend toward more inpatient facilities," said Jennifer Morales, communications manager for the National Hospice Organization. A 1995 survey of inpatient hospice facilities by her organization found that more than 20 percent had opened that year.

Reasons for the growth of inpatient care, she said, include more patients who do not have a primary caregiver at home, insurers finding that inpatient hospice stays save money compared to staying in a hospital, and patients who do not make a decision to seek hospice care until they are already very ill.

Also, inpatient units offer a chance for a patient who has "an acute episode" to receive care without being readmitted to a hospital, said Jenny Schrom, director of managed care for the Hospice Alliance, which includes a dozen hospices in the Baltimore-Washington area.

In the area, Stella Maris Hospice Care operates a hospice floor in its nursing home in Towson and one at Mercy Medical Center in downtown Baltimore.

In addition, the Joseph Richey Hospice operates in a converted house downtown. And Hospice of the Chesapeake, which has been providing home hospice care since 1979 from its offices in Millersville, plans to dedicate the six-bed Chesapeake Hospice House, now under construction, in Linthicum on Oct. 25.

Planning for the Gilchrist Center began when Jeanne Gilchrist Vance of Monkton, now board chair for Hospice of Baltimore, offered funds. Ultimately, Vance contributed $4.75 million toward the $8.3 million total cost of the Gilchrist Center, which is named for her maternal grandparents, according to Lori Raneri, director of development for Hospice of Baltimore.

Although the building is paid for, Hospice of Baltimore continues fund raising to build an endowment to help cover operating deficits, Raneri said.

About 10 percent of the care at Hospice of Baltimore is provided without cost to patients who cannot pay. Nationally, according to the National Hospice Organization, about two-thirds of hospice care is paid by Medicare, about 15 percent by private insurance and about 9 percent by Medicaid programs.

Robert P. Kowal, CEO of GBMC, said, "Hospice programs lose money. We could not operate this without philanthropy. We lose about a quarter of a million dollars a year."

Twelve beds are operating at Gilchrist Center. Another 12 are expected to open by late next month. Some patients come to it from GBMC and some from Hospice of Baltimore's home care program, but it is also receiving patients from other hospitals and home care programs.

Pub Date: 9/19/96

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