Like many healthcare institutions today, Indiana University (IU) Health Bloomington has long desired a dedicated location outside of its main hospital to care for terminal patients and their families.

Today, these services are being provided in such a facility. Through hard work and dedication of the project team and funds raised entirely by the hospital’s foundation, a new, freestanding, 12-bed inpatient hospice house has been created, providing excellent care in an environment designed specifically for this purpose.

Typically provided to patients at home or in an acute care setting, hospice, palliative, and respite care can now be administered in this new homelike setting nestled into the rolling hills of southern Indiana.

There was an overall consensus that the facility should be a beautiful and peaceful place compatible with the spiritual needs of the local community. The hospital chaplain emphasized that the building should have “no hospital feel” and “be a comforting place for guests to spend their last days on Earth.”

Since the mid 1970s, when hospice care gained acceptance in America as the most innovative, comprehensive, and humane care available to people with limited life expectancies, demand for hospice care has increased every year. To meet this demand, the number of freestanding hospice care facilities has grown steadily over the last few years.

One of the most important developments in expanding access to quality end-of-life care was the passage of the Medicare Hospice Benefit in 1982. By 1995, hospice had become a $2.8 billion industry with approximately $1.9 billion of that amount coming from Medicare alone. Medicare and Medicaid, along with private insurance, will help pay for services provided at the IU Health Bloomington facility.

“The hospital anticipates the hospice to be operating at productive capacity for the initial eight patient rooms by the end of 2012. Only after this is achieved and it is deemed necessary to add bed capacity will the hospital build out the remaining four patient bedrooms, which were shelled in as part of the original construction,” says Ruth Ann Morris, vice president of patient care services and chief nursing officer at IU Health Bloomington.

The hospital’s recently retired director of hospice care, Ellen Surburg, worked in the hospice and palliative care fields for 21 years. Prior to this, she worked face-to-face with patients and their families, and found several consistent feelings among them. They were very satisfied with the experience and care they received in the hospital, yet they desired to receive such care in a more homelike environment.

Family members’ satisfaction of the overall experience was based on the caregivers being present and involved throughout the remaining days of their loved ones’ lives. This new facility is a culmination of her dream.

The medical staff at IU Health Bloomington, the Bloomington Hospital Foundation, community representatives, and the design team brought their collective resources and skills together to create the end result.

“The team worked through many challenges to deliver a creative solution for this site,” says Bill Cooler, principal architect and president of Cooler Design, Inc., based in Indianapolis. “We all knew this facility was going to fill an important void in the local community and that it was critical for us to work with the Bloomington Hospital Foundation in the development of gift-giving opportunities.”

Ultimately, the project was entirely funded with community donations in fewer than 18 months. “We would not be here today without the generosity of those who stepped forward,” says Debbie Lemon, chairwoman of the Bloomington Hospital Foundation. “We are so blessed to have so much given to us.”

After reviewing multiple potential sites for the new building, it was deemed best to utilize one of the hospital’s existing properties located close to a state route, providing ease of access for families and friends. The building was nestled on this 3.3-acre sloped and wooded tract of land. Outside the immediate development are grounds, which have been designated a National Wildlife Federation-certified habitat, that can be viewed from the front porch, expansive decks, and a brick patio.

Walking paths have been installed throughout the property. The existing site posed several challenges to the design team, including shallow bedrock formations and a tremendous cross slope that made both structural stability and grading difficult. Site benefits proved to be just about perfect for patients and their families. It includes extensive mature vegetation and a creek bed that were both incorporated into the design and layout of the house. A large wooden deck spans the creek and allows patients and family members to experience the best Mother Nature has to offer.

Enter the front door made of stained rustic mahogany wood, take a few steps inside the craftsman-inspired hospice house, and one quickly recognizes that this is a special facility. A wooden-cased window in the entry provides a view toward the family great room and limestone fireplace hearth. A warm and inviting space for families to gather was the desired effect staff and project team members felt was vital, given the setting of the facility.

A few more steps inside, attention to detail includes a period-inspired coffered ceiling with amber-colored light fixtures, arts-and-crafts-inspired wainscot paneling, rail and style doors, wide casings, and comfortable furnishings.

To facilitate the spiritual process, the individual rooms exude residential warmth. The furniture, carpeting, and overall décor reflect a homelike feel. Guests are encouraged to bring small mementos from home to further personalize their environments. Structural design has been carefully thought out to minimize noise and foot traffic.

Patient dignity and comfort have been attended to with careful thought to conceal oxygen sources in bedside cabinets, along with the lift systems to transport patients from their beds to the adjacent toilet/shower room.

Other amenities, such as flat-screen TVs and refrigerators, are in each room. A sleeper sofa lets family members comfortably spend the night. Large expanses of windows within patient bedrooms and public spaces not only let in an abundance of light, but also take advantage of views out to the woodlands and surrounding landscape, thus helping patients and families feel calm and at peace.

The facility also has a spa room with a whirlpool tub for the patients to help relieve pain and stress.

Family interaction and support is facilitated in many ways. A great room is a focal point for interaction with family and guests, and includes both a residential kitchen and dining table, and an adjoining children’s playroom to allow for interaction of residents with family members of all ages.

Nearby, a laundry room is available where families can do personal laundry. A large sunroom allows family members to gather outside the bedroom and continue to enjoy large expanses of windows facing the woods.

A focal point in the facility is a quiet meditation room. The spiritual tone of this space is enhanced by a tranquil stained glass window and tiled wall with a soothing water feature. The window, which can be seen from both the exterior and interior of the building, is titled “Lift.” The design, inspired by wind and cloud formations, is symbolic of caregivers helping to lift people both physically and emotionally, along with one’s final spiritual release. A subtle water motif can also be found in the carpet tile design.

The carpet tile has a “green” story, as it helped contribute to both the
Materials and Resources, and Regional Materials credits of LEED. “Certified” status is anticipated through the USGBC’s third-party verification program.

Portions of the carpet have recycled content and are also sourced and produced within 500 miles of the project site, as is the limestone used on the fireplace hearth and exterior siding. “Obtaining LEED certification is crucial to the project’s success,” says Chris Molloy, president of the Bloomington Hospital Foundation. “The principles of LEED and being environmentally friendly fall very much in line with both the thought processes of the community and principles of hospice care.”

By certifying the project, Molloy and his team found this to strengthen the fundraising campaign. The city of Bloomington and the people of Monroe County and surrounding areas have a very strong commitment to preserving the future. It is a LEED Silver Bike Community, encouraging people to pedal more and drive less while conserving gas and improving health in the process. Additional green project strategies included a geothermal mechanical system, energy-conserving building envelope, daylighting, and lighting control measures. The project is IU Health Bloomington’s first experience with LEED. HCD

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