Hospice Residences Alleviate Intense Pressure on Health Care System with Compassionate Care


Building Rendering © Courtesy of Neshama Hospice

Talking about end-of-life care is rarely easy, but when it happens with compassion and thought, most people share their desire to die at home. Not a surprise, since it’s a natural impulse to spend time with the ones we love in an environment that is comfortable and non-clinical. The harsh reality, however, is that about 60 per cent of all deaths in Ontario occur in acute care hospitals, even though many of these patients could have died at home if adequate support had been available.

But for some people, dying at home is not an option—they may require more supportive round-the-clock care, or they may not have the necessary support system. It can be devastating to learn that your end-of-life wishes to die at home can’t be fulfilled. Still, for those patients, a hospice residence where 24/7 support is available in a warm, home-like environment surrounded by loved ones is the most meaningful and impactful choice. And critically, it would keep those patients out of the hospital.

Investing in hospice residences makes sense. With demands on hospital beds exceeding current capacity, redirecting patients facing end-of-life to hospice residences would free up much-needed beds in acute care hospitals and provide deeply compassionate care in a home-like environment in a more economically viable model for our system.

A new hospice residence is taking shape in North York called Neshama Hospice. Driven by a desire to provide high-quality, compassionate comfort to people approaching end-of-life in a home-like setting, a group of community members is in the final fundraising stretch to break ground in the Bathurst-Wilson neighbourhood. The Ministry of Health and Long-Term Care has already committed to subsidizing the funding of the beds, and the city has approved its drawings.

"Neshama will bring exceptional clinical expertise of an inter-professional team," explained Dr. Sandy Buchman, one of the founders of Neshama Hospice. "But what's special about a hospice residence is that the approach to medical care focuses on addressing physical, psychological/social, and spiritual/existential needs of patients and families."

Neshama is a Hebrew word that means spirit or soul. The community members chose it to describe the philosophy and approach to care. “We want the care to be directed to the essence or spirit of the individual being cared for, to their personhood, reflective of their unique individual background, culture, values, and faith. In other words, true person- and family-centred care,” explained Co-founder Debbie Berlin.

Hospice Care also makes economic sense for our healthcare system. In 2014, the Ontario Auditor General’s Report showed that the cost of end-of-life care in an acute care hospital was $1100 a day compared to $460 a day for hospice residences. There is an estimated savings of about $9 million for every 10 per cent of patients who can be shifted from receiving palliative care in an acute care hospital to receiving care at home or in a hospice.

One of the intense pressures on acute care hospitals is patients waiting to be transferred to more appropriate care settings. Often referred to as Alternative Level of Care (or ALC) patients, 40 per cent have a prognosis of fewer than 90 days. In Ontario, $161 million could be saved annually if ALC patients were cared for in the appropriate setting, such as a hospice residence, in their final three months of life.

“I wish care in a hospice residence like Neshama had been available to my beloved mother when my family faced the end of her life. Everyone deserves to live out their final days in peace and with dignity. I feel honoured to be part of building this important resource for our community,” said Board Chair Mindy Herman.

To learn more about how you can support compassionate end-of-life care at Neshama Hospice, visit us at

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About Neshama Hospice

At Neshama Hospice, we value the essence and uniqueness of every individual and honour what is meaningful to them at end of life.


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