OC’s The Heavenly Home embraces hospice patients

It didn’t take long for Joanne Saxe to ease into The Heavenly Home in Mission Viejo.

Heidi Emmert describes her 83-year-old mother’s amazement when she brought Saxe to the board-and-care home on a quiet cul-de-sac off La Paz Road. Saxe saw the room designated for her – at the front corner of the house, with a spacious private outdoor patio – and instantly felt at home.

“She said, ‘Is this my bed? Can I get in it right now?’” Emmert recalled seven months after her mother’s passing, unable to hold back tears.

Saxe had been diagnosed with small cell lung cancer on March 1, a terminal disease so aggressive it quickly overwhelmed her family. The retired teacher was suffering so terribly, she had become too scared to leave her house in San Juan Capistrano.

Moving to The Heavenly Home hospice house brought peace to everyone.

Emmert said her mother was able to spend her last days in comfort at The Heavenly Home, a nonprofit residential care facility whose six beds are dedicated exclusively to the elderly who are dying.

It’s among a mere handful of hospice-focused board-and-care homes in California.

Saxe died the morning of March 28 – five days after arriving – in the bed she couldn’t wait to climb into, loved ones at her side.

She was only the second resident at The Heavenly Home, which opened its doors in early February after several years in development.

Emmert, who works full-time, felt relieved to have found such a welcoming place with 24-hour caregivers her mother had come to love.

“Honestly, this is where you want to spend the last days of your life,” Emmert said.

“It is so peaceful.”

‘They are the best’

The Heavenly Home is operated by the nonprofit Southern California Hospice Foundation, an organization fueled by community donations, a dedicated staff and board, and the persistence of Executive Director Michelle Wulfestieg.

The foundation has helped people in need of support since its start in 2002. That outreach has included financial and other basic assistance, from food deliveries to transportation, and granting the wishes of the dying, such as a last-minute wedding ceremony.

But the foundation itself is not a hospice service, which provide end-of-life care to people deemed to have six months or less to live. The six residents of The Heavenly Home are served by six different hospice services.

Government programs, such as Medicare and Medicaid, or private health insurers typically cover most of the cost of hospice service, which largely involves symptom and pain management. It also can include emotional, mental and spiritual support. A social worker may be involved.

It’s been Wulfestieg’s mission for the foundation to open an affordable respite for the dying. Every day, she said, she turns down desperate people calling on behalf of a family member. All six bedrooms have been occupied since June.

“We have seen the dire need for hospice to be a place, to be a home – because a lot of people can’t die at home,” she said.

“They might have difficult living situations, or they don’t have family and friends to care for them.”

Wulfestieg escaped death twice herself after suffering two strokes, at ages 11 and 25. Now in her early 40s, she became executive director of Southern California Hospice Foundation in 2010.

Being placed on hospice does not include a place to stay, nor does it pay for daily caregiving – cooking meals, bathing and attention to other personal needs. Most people eligible for hospice are being served in their homes and those of relatives, at hospitals or in nursing care and assisted-living facilities.

Residents of The Heavenly Home can stay as long as they are certified for hospice care. Under government rules, hospice eligibility is re-evaluated every six months.

Since the arrival of the first resident on Feb. 8, The Heavenly Home has taken in a total of 11 people. Five, including Emmert’s mother Saxe, died at the home.

The décor, furnishings and much of the labor that gives The Heavenly Home its comfy atmosphere – inside and out – was provided by donations and volunteers.

Fall decorations – pumpkins and gourds, faux autumn-colored leaves – accent the foyer and living room, where gentle piano music plays on a TV monitor. A cart with binders for each patient sits unobtrusively off to one side. A large soothing seascape painted by Orange County artist Andrea Moni graces a wall.

Estimated cost for this first year of operation is $500,000.

One of the residents, Archie Cachola, is a pediatrician who once cared for children with cancer at local hospitals, including Children’s Hospital of Orange County and Miller Children’s and Women’s Hospital in Long Beach.

Now Cachola, 71, is dying from thyroid cancer that has spread to his bones.

A once-robust healer who for a time also ran his own catering service, Cachola needs help to move about, is hard of hearing and suffers severe pain in his back.

A native of the Philippines, he never married, never had children of his own. His dream had been to open a hospital to give free care – all volunteer – to sick kids, “my children,” he calls them. He had to retire two years ago, after his diagnosis.

Cachola was living alone in his apartment earlier this year when he had a fall. A home health service contacted The Heavenly Home. He came in May.

“I’m so lucky to be placed in this board and care,” Cachola said on a mild autumn day, resting on an outdoor couch beneath the gazebo in the home’s backyard.

“They are the best.”

He described the home as “comfortable and quiet” and the caregivers “excellent.”

“I’m really happy,” he said, adding with a chuckle, “my standard is very high.”

Wulfestieg stood to one side of him as he chatted and on the other sat his chief caregiver, certified nursing assistant London Hamilton.

Hamilton came to The Heavenly Home as a temporary worker through a registry service. She had worked at Children’s Hospital in the past and recognized Cachola. She knew well his reputation as a physician. Right away, she wanted to honor his lifetime of concern for children by caring for him.

“He set the bar for the other oncologists,” Hamilton said of Cachola. “It brings tears to my eyes because of all the wonderful things he did for so many children.

“I wanted to be there for him in his time of need.”

Hamilton said she initially thought The Heavenly Home would be like any other board-and-care assignment. But she likes it so much she’s asked to become a permanent full-time employee.

“When you step through the door, you just get this positive vibe,” said Hamilton, who was pulling a double shift that day.

“It’s no longer work – it’s like you are taking care of family.”

Low-income patients welcome

The Heavenly Home employs 12 people, including a house manager and caregivers that rotate in and out, two always on site most of the time and one overnight. Some work full-time, some part-time, some per diem.

Wulfestieg says finding and keeping staff remains a challenge, as it has been throughout much of the healthcare industry since the pandemic.

On a sliding scale based on income, residents pay anywhere from $40 a day for their board and care to up to $425 a day. The standard industry cost for 24-hour care is about $500 a day per patient, Wulfestieg said.

“It was really important to us that we were able to meet the needs of lower-income patients,” she said.

The shortest stay at The Heavenly Home was 15 hours; the longest has been that of a bedridden woman who arrived in early April.

One of the residents had been paying as much as $30,000 a month for 24-hour in-home care in a previous residence, Wulfestieg said.

The Heavenly Home’s ability to cover the cost of care is helped by a special status granted by the state to care for low-income hospice patients who have what is known as an Assisted Living Waiver.

The waiver allows The Heavenly Home to bill Medi-Cal, the state’s version of Medicaid health insurance for the poor, for a portion of the care low-income residents receive. This is in addition to elderly residents on Medi-Cal turning over their monthly Social Security benefits – about $1,300 – to pay for their stay.

Half of the residents are there on the waiver, the other half pay privately.

But that is still not enough, Wulfestieg said. An endowment fund established with donations to Southern California Hospice Foundation fills the remaining gap.

So far, the foundation has raised a little more than $2 million for the endowment fund, with a goal of $5 million.

“People have been very generous in Orange County,” Wulfestieg said. “They’ve been very open to this idea.”

‘A sacred place’

Community support helps The Heavenly Home provide the little touches that can make someone’s last days among their best.

Cachola celebrated his birthday the last weekend of October by cooking a meal for the residents and a few invited friends, with “sous chef” Hamilton’s help. They wore matching aprons and chef’s hats.

Family members are encouraged to visit and be themselves.

Emmert said either she or her brother came every night to stay with Saxe. At one point during her mother’s stay, up to 22 family members – some from out of state – came together to celebrate Saxe, Emmert said. They set up a taco bar and barbecued on the backyard patio.

Emmert remains a dedicated supporter and regular visitor to The Heavenly Home. Sometimes she only goes as far as the front porch, to peek at the statue of an angel the family donated in Saxe’s honor for the patio outside her old room.

“This is a sacred place to me,” Emmert said.

On a recent afternoon, Dana Graff sat in a recliner as her mother, Marilyn Rosenlof, 87, dozed nearby. Her mother had been in an assisted living facility in Santa Barbara that was costing $10,000 a month before she became bedridden.

Graff relocated her mother to a little house she and her husband purchased near their own home in Mission Viejo. Then Rosenlof went on hospice care in March.

“We were very naïve,” Graff said, “thinking we could keep Mom at home and help care for her.”

Rosenlof came to The Heavenly Home in mid-June, the last space that’s been available. Graff likes how the staff respects her mother’s own schedule.

“If she doesn’t want to wake up for breakfast, she doesn’t have to,” Graff said. “They’re all so loving, and she loves them.”

Southern California Hospice Foundation hopes to open a second hospice house like The Heavenly Home. The state is reviewing a grant proposal to cover the cost of purchasing another house and funding five years of operating expenses.

“We’re really trying to help fill a huge gap for end-of-life,” Wulfestieg said. “It is caregiving and it is housing.”

Good days to come

The oldest resident, Jean Corcoran, has lived at The Heavenly Home since early May. Her 104th birthday will be Nov. 18. She has bouts of confusion and dementia.

On a warm afternoon last week, Corcoran barely moved in bed, tucked under several blankets. She was not at her sharpest at that time of day but told some of her life story, never lifting her head from her pillows.

Born in West Virginia, she lost her own mother in childbirth and, when she was 3, her father placed her in an orphanage.

She was a Rosie the Riveter welder in a Midwest factory during World War II. She had been a department store model. After coming to California in the post-war boom, she worked as a nurse. Her daughter is in a nursing home. Members of her church are steady visitors.

She is one of the lower-income patients with an Assisted Living Waiver.

Even in her diminished capacity, Corcoran maintains a stylish flair, Wulfestieg said: “This is a woman who still puts on makeup and does her nails. She’s a total fashionista.”

The day after Halloween, Corcoran was the guest of honor at a fundraising event for Southern California Hospice Foundation called “Dolled Up.” The outfit the foundation bought for her to wear included a white faux fur jacket, a shimmering top and sleek black pants, and a princess crown atop her newly coifed white hair.

When she arrived at the event inside the Pacific Club in Newport Beach, Corcoran let out a “Wow.” There was vanilla birthday cake and “Happy Birthday to You.”

At the end, Corcoran expressed her gratitude with tears of joy and repeated over and over, “Thank you, thank you, thank you.”

Source: Orange County Register