Albert Locatelli, a former Hollywood art director and resident at Sarah House who is dying of metastasized breast cancer, said that he felt “saved” when he came to Sarah House.” “It gets weird for a lot of people when you don’t have money.”
Sarah House hospice, which serves low income individuals, was recognized recently when the California Hospice and Palliative Care Association (CHAPCA) presented it the 2010 Outstanding Program award. In a press release, CHAPCA described Sarah House as “a place of sanctuary and warmth for residents, their families and their staff.”
Susan Negreen, President and CEO of CHAPCA, said that when choosing the award recipient two factors distinguished Sarah House. First was the fact that Sarah House is not a medical facility and second was that it has garnered “tons of community support.”
Sarah House, tucked away on the corner of Modoc and Las Positas and daily passed unnoticed by hundreds of motorists, is an eight bed facility based on a social care model. This means that it takes a holistic approach to the pain and dying process, addressing the social, psychological, physical and spiritual aspects of mortality. After death every dying resident receives a ritual cleansing in which family members are invited to participate.
The difference between a social and medical care facility are immediately obvious when one walks in the front door of Sarah House. There is always a small altar in the lobby that pays homage to the last person who died. Otherwise, it looks much like a house, a rather large house with a cavernous living room area and commodious kitchen where residents can indulge in their favorite films or foods.
Unlike in a medical facility, there is no division of labor among the staff who are all Certified Nurse Assistants. The average bed cost per day is $350 compared to the $650 per day national average.
Sarah House is the first hospice of this type and in fact it required legislation which was written by then-state assembly member Hannah-Beth Jackson and passed in 2004. Originally, it provided care for AIDS patients, but as pharmaceutical innovations vitiated the effects of the disease, Sarah House transitioned to more general end-of-life care. Despite its cost-efficiency Sarah House—because it is not a medical facility—does not receive funding from Medicare.
For the past 18 months Sarah House, which only takes low-income residents who have a prognosis of less than six months and earn under $41,450 per year, has been running a waiting list. This has never happened before. It normally averages about 50 deaths per year, but they have had 39 in just the past five months.
Sunday attributes this to the recession which is hardest on the most vulnerable. Public Health Department Deputy Director Michele Mickiewicz said that applications for the Medically Indigent Adult Program are on the rise as are visits to county clinics—from about 125,000 to about 136,000 in the past two years—and the number of visitors who do not have insurance.
Visiting nurse Deborah Molnar nominated Sarah House for the CHAPCA award. She has been working in hospice care for a long time, but she feels the social model is “more caring and compassionate.” When she heard about the award she said, “I thought this was the place. It provides wonderful care to patients and their families.
Molnar said that both residents and staff at Sarah House are all on a similar “frequency,” one which has been carefully tuned by House Manager and former Independent Local Hero Debbie McQuade.
“I feel really supported here,” added Molnar. “I feel acknowledged for the work that I do.