San Francisco’s Zen Hospice Has Closed Its Doors

Credit: lionsroar.com

One of San Francisco’s oldest and most revered inpatient hospices closed its doors this month. Already, the old Victorian building on Page Street that housed the Zen Hospice Project is empty and bare. The furniture is gone, the floors are covered with tarps, and the building — by all appearances — is being prepped for sale. The last guest (the hospice didn’t call its clients “patients”) died in May.

It’s the end of an era in San Francisco. When the Zen Hospice guest house opened in 1990, it was at the height of the AIDS crisis, when dying men were languishing in their homes because no hospital would allow them in. With only 5 beds and a cadre of dedicated volunteers from the San Francisco Zen Center, the hospice provided around-the-clock care to their dying clientele. It also partnered with Laguna Honda Hospital, a long term care facility that dedicated 60 beds to hospice and palliative care. There, volunteers and a small team of dedicated doctors and nurses cared for their clients as they approached the end of their lives. 

A Unique Model of Care

Then, in 2010, the Zen Hospice guest house underwent a major transformation. The building was remodeled, and the volunteers were joined by a 24-hour nursing staff who provided one-on-one, specialized care to the guests. Charismatic hospice and palliative care physician B.J. Miller joined the staff, and Zen Hospice became widely known for providing some of the highest quality care to the dying anywhere in the world. Donations poured in, and the project thrived. Volunteers sat with the dying, prepared special meals for each of the six guests, and baked cookies every day. Meanwhile, a dedicated staff of health care professionals supported their clients in every way possible as their lives came to an end.

Zen Hospice staff and volunteers gather in front of the guest house in 2016
Credit: ZenHospice.org

Sadly, however, donations to the center have dropped off precipitously over the past few years according to Zen Hospice Project executive director George Kellar. Things got particularly bad after the 2016 election, he told KQED, when, in response to the policies of the Trump administration, long-time donors began steering their philanthropy to causes like social justice, voter outreach, homelessness and immigration reform. Kellar tried to negotiate an agreement with a few private insurers to pay for some of the hospice services. But as of June, no agreement had been reached, and the hospice was $1 million short of its $2 million operating budget. Something had to be done.

A New Era?

The announcement of the demise of the Zen Hospice guest house was carefully worded, stating that operations have been “suspended” and that the project still held out hope that a donor could be found. And one would think that in California’s wealthy Bay Area, where tech millionaires abound, that wouldn’t be an impossible feat. But thus far no one has stepped up.

And so, after 30 years of providing compassionate care for the dying, “we’re letting it go” Kellar said. In the booming San Francisco real estate market, the 5 bedroom Victorian could fetch a tidy $5 or $6 million — money that can then be funneled into the volunteer program at Laguna Honda and the Mindful Caregiver Education program, which teaches caregivers how to care for their patients and themselves.

“Our mission is to transform the experience of dying and caregiving,” Kellar told KQED. “And while we started at the bedside and continue at the bedside at Laguna Honda, it is now a time to focus on helping other people at the bedside by training and education.”

A worthwhile goal, certainly. Still, for many long time residents of the San Francisco Bay area, the loss of Zen Hospice is difficult to accept.