All too often, say founders of Casa Cielo, the final days of life for an elderly person or patient succumbing to a terminal illness can be far more unpleasant than they could be.
Some people “get traumatized right at the end … and then that’s the memory of the death,” said Frances Salles, executive director of Coming Home Connection.
The nonprofit, which offers a variety of in-home care services, seeks to change that with Casa Cielo, one of its newest initiatives.
“This is a home to die in,” Salles said last week at Casa Cielo, housed in a unit at the Montecito of Santa Fe assisted-living community.
The two-bedroom apartment, set to open to residents July 1, will offer an alternative to nursing homes and hospital beds — or even a relative’s home — for people facing their last month of life, providing a “home-like environment that is safe, comfortable and compassionate,” Salles said.
Caregivers with Coming Home Connection will offer round-the-clock basic care, and hospice workers of each patient’s choosing will provide medical services, allowing family members and friends to be present with their dying loved one, saying farewell without the strain of also acting as caregivers.
The effort is part of growing nationwide trend, with about 30 such homes across the U.S., ranging from two-bed units to eight- and 16-bed state-of-the-art homes that Salles described as “spas for the dying.”
While Coming Home Connection is spearheading the project, Salles said, it is working in a partnership with several organizations — including Montecito and local hospice agencies — as well as the city of Santa Fe, which is providing funds to cover services for low-income people.
Anchorum St. Vincent, a nonprofit that co-owns Christus St. Vincent Regional Medical Center, and the Christus Fund, an organization tied to the hospital that provides grants for health-related initiatives, provided startup funding.
The nonprofit Kitchen Angels, which delivers meals to people confined to their homes, will prepare food for Casa Cielo, and Legacy Hospice donated beds, Salles said, adding that Ambercare, another hospice organization, helped develop the home’s policies and procedures.
Ashley HomeStore donated several pieces of furniture, she added.
Last week, there were boxes stacked in the kitchen, waiting to be unpacked, and artwork leaning against wall, not yet hung in a living room flooded with sunlight.
But the work will be complete when organizers showcase Casa Cielo during a public open house Friday and Saturday.
Eventually, Salles said, she hopes the facility will become an educational center for the community to learn “how to die well.”
“If you have some money,” she said, “you have options — usually, but not always — but if you don’t have money … it really means dying in a hospital.”
According to a 2018 study from the Stanford University School of Medicine, 80 percent of Americans would prefer to die at their home, but only about 20 percent do; 60 percent die in hospitals and 20 percent in nursing homes, the study found, citing several reasons: an inaccessible home design, a lack of money to pay for in-home care and a lack of family members who can offer assistance.
Whatever the reason, said Karli Wheeler, a Casa Cielo advisory board member, “It’s clear there’s a need” to better serve people approaching the end of life.
Wheeler, a former digital learning coach with Santa Fe Public Schools, made a recent career change to become a death doula — a personal guide for the dying and even healthy people making end-of-life plans. Death doulas also provide bedside services for dying clients, offer grief counseling for family members and help with funeral plans, she said.
Asked how her clients might benefit from a home like Casa Cielo, Wheeler spoke of a former patient who was living off the grid in Pacheco Canyon, in a rustic home with no running water. Hospice workers needed four-wheel-drive vehicles to reach it she said.
Caregivers found a small rental home in the city where the woman could have died in more comfort.
But when the owner of the casita learned her tenant was dying, Wheeler said, she asked the woman to leave.
The woman returned to her rough dwelling in Pacheco Canyon.
Salles said Casa Cielo is just the first phase of the initiative, which she expects to expand: “Two beds is fantastic, but it’s not going to meet the need.”
In a city with an ever-graying population, the demand for elderly care is growing at a rapid pace. Coming Home Connection, founded in 2007 by Glenys Carl, who was named as one of The New Mexican’s 10 Who Made a Difference in 2017, has seen requests for its services increase.
The organization connects people with caregivers in the community and offers some free, volunteer care to low-income people. Some of its clients — it serves some 50 to 60 at any given time — just need help for an hour a week with a shower, Salles said, while others receive 24-hour care.
Family members caring for a spouse or parent with dementia often request just a few hours of help from the organization each day or week so they can take a break, Salles said, adding the demand for this respite service has significantly risen in recent years.
“We’re always in need of volunteers,” she said.
The need will soon increase further as the nonprofit launches a new initiative, Coming Home Kids, to offer respite for parents caring for children with acute illnesses.
An end-of-life home for hospice patients is an idea that’s been brewing for a decade, Salles said.
It began with Carl, who has retired from the nonprofit and is working on a project similar to Casa Cielo.
She plans to open a three-bedroom facility called Scott’s House, named for a son who died from a traumatic head injury
30 years ago in Australia.
Carl said she’s proud to see Coming Home Connection start an end-of-life home.
“We’ve never had any hospice houses in the whole state,” Carl said. “… The need is really high.”
Rachael Hemann, a spokeswoman at Montecito, agreed there’s a need in Santa Fe for such a home and said Montecito is excited to be a part of it. “Not every person, every family, has support they need at that time in their life,” she said. “Casa Cielo is filling that gap.”
Tenants of Casa Cielo will be considered residents of Montecito, giving their families access to its restaurant, lounge, outdoor seating areas, library and even spa services.
Jeanette Iskat, client services manager with Kitchen Angels, said her team is looking forward to serving the home’s residents.
“We believe food is medicine for life, even if it’s the end of your life,” she said.
Salles said the initiative is timely.
“We haven’t done death well in America,” she said, with most people avoiding the topic or approaching it with fear.
But she sees that mindset changing, and she hopes Casa Cielo will serve as a catalyst in Santa Fe for people to embrace the idea of a peaceful passing.
“I want people to live until the point they die,” she said.