Providence Care recently opened AB Smith Homestead House, a 10-bed hospice residence dedicated to providing compassionate end-of-life care in a home-like environment.
It’s a milestone achievement more than 10 years in the making and is Kingston’s first hospice, leading to new approaches to palliative care delivery in the region.
“We have a new space which has happily necessitated some new approaches, and new options,” explains Providence Care’s Clinical Director of Palliative Care, Dr. Danielle Kain. “We are very fortunate to have palliative care beds on Heritage 2 [at Providence Care Hospital] but the patients admitted there are not necessarily the same patients who are going to be admitted to hospice. From our standpoint, and our partners, we now have more options to talk to patients about where they might want to receive end-of-life care.”
According to the Royal Commission on the Future of Health Care in Canada report (2002), better known as the Romanow report, more than 70 per cent of Canadians say they would choose to die at home if given the option. However, when circumstances make that no longer feasible – due to complex care needs or caregiver fatigue – having a compassionate alternative becomes essential. Dr. Kain says Providence Care’s hospice house offers that alternative: a comforting, supportive environment that eases the burden on families when home is no longer the right option.
“There can be this sense of failure for a patient’s loved ones or care partners when they can’t adequately provide care at home,” says Dr. Kain. “I do feel AB Smith Homestead House will ease that burden. It’s not quite home, but it’s not a hospital either. It’s not that the care that we provide in the hospital is anything less than excellent care, but, going back to that original [Romanow] report, Canadians don’t particularly want to die in hospital.”
Providence Care’s AB Smith Homestead House is an expansion of existing in-hospital palliative care services and community-based hospice services. Located at 152 Phillips St. in central Kingston, AB Smith Homestead House features private suites with patios, family gathering spaces, a spiritual room, a children’s corner and a large family-style kitchen, all to foster a sense of warmth and community.
“In hospice, the patient is usually very close to end of life, and the focus tends to be exclusively on comfort. Earlier on in a patient’s illness journey, and depending on a person’s goals of care, I have people that I bring into the hospital to conduct investigations to see if there are things that we can fix. If I can’t fix the cancer, for example, maybe I can fix the pneumonia or the electrolyte abnormalities or whatever’s brought them to hospital. Whereas hospice is focused exclusively on their comfort; on relieving suffering. At this point in their trajectory of illness, it doesn’t always matter what is causing the symptoms, what matters is that we help with those symptoms and that suffering.”
Not only does the newly opened hospice house expand options for patients and their families, but it also helps to close a gap in care in the Kingston region.
“The Canadian Cancer Society released a report in 2023 on the state of hospice care throughout the country that stated, on average, most regions have about 50 per cent of the hospice beds they need. And of course, we were below that national average considerably, not having any here in Kingston. So, the opening of this hospice is accompanied by a big sense of pride. It takes a village to make something like this come to fruition, and the physicians involved from our group [Queen’s Palliative Medicine] are only one small part of it.”
The village behind turning AB Smith Homestead House from a dream into reality is the community. Funded largely through community donations, Providence Care’s hospice house is a project funded by the community for the community which will require continued support.
“Hospices are not funded like hospitals, and they require community support to keep their doors open,” explains Dr. Kain. “We will need ongoing fundraising and community engagement to stay operational.”
For the last 10 years Dr. Kain has worked exclusively in palliative medicine. She describes palliative care as both medical support and being a compassionate presence during life’s most vulnerable moments.
“It’s incredibly gratifying and uplifting to have the skills and training to provide care in a sacred space where someone is so vulnerable. I’m not the one saying there aren’t any more treatments – I’m the one saying, ‘You have pain, I can help you with that. You want to reconnect with your mother, who you’re estranged from? I can help you with that. You just need to sit here and cry for 20 minutes? I have the time to do that with you, and to carry some of that burden.’ It’s incredibly gratifying work.”
The interprofessional team at AB Homestead House includes registered nurses (RNs), registered practical nurses (RPNs), personal support workers (PSWs), volunteers, physicians, and other health care and support professionals who work collaboratively to provide high-quality, compassionate care. The care the hospice team provides extends beyond just the patient and also includes bereavement support and grief counselling for care partners throughout the process.
