“Death ends a life, not a relationship.”  ~Robert Benchley

In Part One of this two part series the reader was introduced to Dr. Steven Jacobsen, Executive Director of Hospice of Santa Barbara.  Hospice of Santa Barbara is located within the RivieraBusinessPark, just behind the Riviera Theater, and has been providing nonmedical hospice services to our community, totally free of charge, for decades.  To review, some of the specific services Hospice of Santa Barbara provides include:

• Helping individuals and families cope with grief related to the loss of a loved one.
• Caring for anyone facing a life-threatening illness.
• Offering up to 15 different kinds of support groups including: “Widows and Widowers,” “Survivors of Suicide,” “Parenting After Loss,” people who have lost young children, people who have lost adult children, and others.
• Care management in which a professional social worker coordinates services.
• Spiritual care by ordained ministers who help individuals and families find hope, meaning, and spiritual comfort.
• Respite care by trained volunteers.
• Volunteer services of many kinds including: cooking, driving, gardening, and many more.
• Complementary therapies that use various forms of massage and energy work to help alleviate stress, fatigue, and pain.

• Community education in schools or businesses where a death has occurred to help people know how to cope and heal.  Hospice of Santa Barbara also provides speakers on related topics.
• Advance care planning where medical social workers meet with individuals, families and groups to help complete forms that make sure that each person’s wishes are known at the end of life. This includes not only authority for medical decisions, but also information about how you want to be cared for, how you want to be remembered, and what you want people to know about what your life has meant to you.

My conversation with Dr. Jacobsen continues in this second and final installment about Hospice of Santa Barbara.

Dr. Miller:  How many members of our community does Hospice of Santa Barbara serve?

Dr. Jacobsen:  Many many more than one might think.  When I began serving as Executive Director in 2008 we were serving approximately 260 people every month.  Two months ago that figure had risen to over 500.  We never dreamed this would be possible.  Yet despite the fact that we have almost doubled in the number of people we are serving, our staff and volunteers continue to attend to each person with individual reverence and skilled devotion.  As long as I have your ear, please allow me to bend it and share with you three stories to illustrate what it is I am speaking of.

Last summer a young woman came to us with Stage IV lung cancer. Our team was very sensitive to the fact that this woman highly valued her privacy, and interacted with her accordingly.  She was visited by Rev. Laura Mancuso, one of our new Spiritual Care Counselors.  The patient had a diverse range of spiritual practices and Laura was able to acknowledge, affirm and support the importance of them all. Laura also provided bi-weekly energy healing sessions in the patient’s home. One of our volunteers began to visit regularly for companionship.  The patient asked Laura to speak with her brother, a cardiologist at the Mayo Clinic.  He told Laura about his desire to connect with his sister across the 1500 miles that separated them.  Laura helped them establish a time everyday when the two of them could be in prayer and meditation together, creating a daily bond of love and support.  The patient wrote down her specific wishes regarding her memorial service, and Laura was able to create and lead the service after the patient’s death, just as she had wanted.

At the same time that our team was caring for this patient, our weekly bereavement support groups were meeting with parents who have lost children. Recently, one of the participants decided it was time for her to move on.  She wrote a parting message to the others in her group.  I would like to share her note with you:

I don’t know how I would have made it through the last couple of years without our loving group.  I have felt so tenderly held in our safe cocoon.  I learned to forgive myself as I saw in all of you that there was really nothing to forgive.  I was able to make it through my days as I witnessed your courage to keep going.   The depth of our love for our precious children was palpable in every group with a beauty that is beyond words and continues to sustain us.  We have walked this tragic path together, sharing in our inconceivable loss and sadness and because of that our bond will always be deep. 

Another program was occurring on six Wednesday evenings, our “Parenting After Loss” group. This is for families in which a mother or father has died.   The surviving parent is faced with the simultaneous tasks of bearing the loss of their spouse and becoming a single parent of their grieving children.  The families come and are greeted by a warm, generous dinner.  They then break into groups – one for the parents (sometimes including grandparents), one for the teens, one for the older children, and one for the youngest children. In the past we’ve had 20 -30 in this program. This fall 61 children and adults signed up.  And, by the way, we were also able to offer, for the first time, a parenting group in Spanish.  One of the families included a boy in his early teens.  Since his father had died, he had regressed emotionally.  But by the third week there had been a significant change in his behavior; he had regained his maturity.  At the end of that evening, his mother told one of our counselors, “I’ve got my son back.”  I offer these three stories to give you a glimpse of the variety of healing work we are doing these days.  Despite serving twice as many people as we did four years ago, the quality and depth of compassionate care we give each individual person remains constant. 

Dr. Miller:  How long do your clients continue to receive services?

Dr. Jacobsen:  I find that people are often amazed at the fact that there is no preset limit on the provision of our services. People who are facing a life-threatening illness can be supported by us as long as needed.  Some people may get the support they need in just one or two visits.  Others who have suffered particularly difficult losses can be helped by us for several months or even longer.  And we offer a “lifetime warranty”…..someone we have served can always come back when they need us.  Through all of this, there is never a charge for our services, and people do not ever need insurance.

Dr. Miller:  Are you able to provide services to the Spanish-speaking members of our community?

Dr. Jacobsen:  Yes, we have six members of our staff who are bi-lingual.  With this team, we are able to help Spanish-speaking people of any age deal with a life-threatening illness or the loss of a family member.

Dr. Miller:  I am aware that there are two hospice organizations in Santa Barbara.  A dear friend recently passed away and she received exceptional end of life medical care at the beautiful new Visiting Nurse and Hospice Care (VNHC) facility on Miramonte Drive.  What is the difference between VNHC and Hospice of Santa Barbara?

Dr. Jacobsen:  It is a difference in focus.  Medical hospices such as VNHC include a strong medical component.  On their staff are physicians, nurses, and aides that can help with pain relief, symptom management, and patient comfort.  They also have social workers, chaplains, and volunteers that help families with caregiving and coping in the last months of a patient’s life and some bereavement services after a death.  As you noted, VNHC recently opened a state-of-the-art facility known as Serenity House where people are getting the very best comprehensive care as death draws near.  Medical hospice care provides extraordinary support to families in these situations.  Much of the funding for these services comes through Medicare and insurance services.  A common limitation, however, is that these services are usually only available when there is a medical judgment that the patient has six months or less to live and the patient is ready to forgo any treatments that are aimed at a cure.  Our contribution is to be available when a patient has been diagnosed with a life-threatening illness but is not ready to forgo curative treatment, or whose terminal prognosis is more than six months.  We can help prepare the patient and family up to the time when medical hospice may be appropriate and we can address what is commonly referred to as “anticipatory loss or bereavement” for these patients and their family members who may be struggling with the fear of a terminal diagnosis. Our bereavement services are available to anyone regardless of when the loss happened or where– last week in Santa Barbara, or several years ago in a far away place. We also serve many families who have lost someone suddenly, such as in an accident or suicide. And, as always, our services are free; insurance is never a question. 

Dr. Miller:  I have heard that you are involved in palliative care in our community. What exactly is that?

Dr. Jacobsen: Yes, strongly, both inpatient and outpatient. These programs are collaborative efforts between Cottage Hospital, Visiting Nurse & Hospice Care, the Cancer Center of Santa Barbara, and Hospice of Santa Barbara.  Working together with each other and the client’s physician, we provide an extra layer of pain and symptom management, as well as emotional and spiritual support to patients and their families, both within Cottage Hospital (Palliative Care Consultation Service) and in the community (Community Palliative Care Team). Bereavement care is offered to the surviving family members as well.  Community-based palliative care is a new innovation across the country, and our local program was recently recognized by the California Hospice and Palliative Care Association (CHAPCA) as an innovative program that raises the standard for excellent in palliative and end-of-life care. 

Dr. Miller:  So, you provide all of these incredible services totally free of charge and to so many each and every month.  How does Hospice of Santa Barbara support itself?

Dr. Jacobsen:  As a non-profit, Hospice of Santa Barbara depends on the generosity of the past, present, and future donors.  Past donors have helped create our endowment, which is managed by an independent board of trustees.  Current donors, local companies, and various foundations also support us. Because we value being free from insurance or government restrictions, we do not accept any funds that would compromise our ability to serve any one in need free of charge. 

Dr. Miller:  Hospice of Santa Barbara clearly has a remarkable history.  What is your vision for the future?

Dr. Jacobsen:  Regardless of medical or technological advances or new social programs, human beings will continue to face mortality and experience grief.  When that occurs without support and understanding, it leads to broken and diminished lives.  When mortality is faced instead with skilled, compassionate, care and support, it can lead to healed lives, deep wisdom and hope.  At Hospice of Santa Barbara, we will continue to provide such care and services for decades to come.

Dr. Miller:  Dr. Jacobsen, I am so incredibly impressed and moved by what I have learned today.  What more can I do to let people know of the wonderful work you and your staff are doing?

Dr. Jacobsen:  Well, in a sense you are doing just that by meeting with me…You are spreading the word to your Healthy Mind – Healthy Future readers who may be in a position to benefit from our services but may not know we exist, and that our services are free.  If someone is being impacted by a life-threatening illness – even if they are actively pursuing a cure – they can call us for support.  If someone is burdened by the death of a loved one who died recently or even years ago, encourage them also to call us.  We deal with a wide range of loss.  No loss – even the most tragic or complicated – is beyond our ability to help.  Remember, we exist to serve those in our community in need.

So, if your readers have any questions whatsoever I would encourage them to call us at 805-563-8820 or e-mail us at info@hospiceofsb.org.  We also encourage folks to call and arrange for a tour.