Bay Area Reporter - August 30, 2007
Kris Larson

"People were dying in droves, sometimes with no family support, no place to be," recalled Rich Nasca, director of Coming Home, about the early years of the AIDS crisis. "There was a group of volunteers who put together a plan and approached the church about taking the convent and converting it and fundraising for it. And they did it. I think it's a wonderful example of community activity, the community working together."

The hospice is no longer filled with AIDS patients, said Nasca. "Since the mid-1990s, when AIDS became a more chronic as opposed to an acute illness, we admit fewer AIDS patients, but we always still admit them. We've had a wider variety of diagnoses: cancer, congestive heart failure."

Unlike an average nursing home, Coming Home feels like a residence, despite the hospital beds in each room. Residents have a sunny deck outside and a common room upstairs, flooded with light and furnished with couches donated by actress Sharon Stone.

Coming Home keeps a nurse on duty 24 hours a day, and employs three home health aides who are present during the day and in the evenings. In addition, the hospice staff rely on their cadre of about 50 volunteers, who do everything from answering phones to doing patients' hair and nails to playing small musical concerts. The hospice also employs 32 people.

"Music and art make people more comfortable," said Nasca, who said that the hospice has been gradually redecorating each room in the 15-bed facility, covering all the walls with nature murals. He also has had a portable sound system installed in every room.

Coming Home is affiliated with California Pacific Medical Center, and operates on a budget of about $2 million annually.

When asked whether it's difficult to stay positive while surrounded by so much illness, Nasca said, "It's just the opposite. It's a wonderful atmosphere. You really know you're providing a transitional service for people. Our goal is that they pass comfortably, with no pain and with loving support around them. ... When a patient does pass, we know we've done well when the patient is comfortable, the family has been supported and it's a comfortable passing."

Observing the hospice supports Nasca's claim. Residents and staff smile at each other in the halls, obviously comfortable together. "Hi, Rich!" one resident said cheerfully to Nasca.

The hospice allows the residents to determine how involved they want to be in the process. "Some patients don't want to know [what will happen]," Nasca said. "They leave it up to the family to process the information. For the most part people are open. They're all here for the same reason, and there's good support from each other, and we help people with acceptance of the process so that it's not a shock, it's not a horrible thing."

For more information about Coming Home, call (415) 861-1110.

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