At hospice, ailing veterans find home

FITCHBURG -- An artificial Christmas tree lights up a corner inside a three-story wooden home perched on a steep hill. A plump wreath is placed on the front door, and inside, garland is wrapped around a banister to the second floor.

There also are large model warplanes suspended from the ceilings, a POW-MIA banner, and 54 American flags carefully folded behind glass in wood-frame cases.

The cases, each with a metal nameplate, commemorate the men who died here in the Veterans Hospice Homestead, a place that founder Leslie Lightfoot says is the only private hospice in the country devoted exclusively to veterans.

It's a placid retreat where ailing veterans can reach the end of their lives in dignity, in a bed instead of a hospital ward or the street, and in the company of caring staff and comrades.

"Coming here is better than going to a hospital," said Bill Bouchard, 49, a Coast Guard veteran with liver and lung cancer. "I have no family left."

The community room where Bouchard sat -- made homelike with a big-screen TV, a large collection of movie tapes, and a long, comfortable couch -- hardly seemed like a gathering place for the dying.

A spirited cribbage game unfolded nearby, the cards slapped with a thwack on a table. Quiet laughter punctuated the conversation among staff and clients. And Ernest Testa, 75, an Army veteran of the Korean War, leaned forward to argue that President Harry S Truman had it all wrong when he recalled General Douglas MacArthur from Korea.

"It's nice to talk to people who understand" the needs and emotions of ailing veterans, said Bouchard, a former Boston resident who moved here in October from Daytona Beach, Fla. "I was getting sicker, and I wanted to see some old friends [in Massachusetts] before I kick off."

The nonprofit hospice, begun in 1993 by Lightfoot, a former Army medic, can accommodate 12 residents in its seven bedrooms. All clients have been diagnosed with a terminal illness, and are no longer able to care for themselves.

For many veterans in the hospice, most of whom served in the Vietnam era, the alternative would likely be an institutional setting, such as a veterans hospital or nursing home -- or worse, the street.

The hospice is designed "to get the guys who had fallen through the cracks," Lightfoot said. "The things about veterans taking care of veterans really means something. . . . Society doesn't really have a feel for what goes on in the life of someone who has been in combat or been in a war."

The emphasis here is on independence wherever possible. Residents help one another prepare meals in the communal kitchen, and some even leave the home for errands or to visit the senior center and library.

"The people here are nice. It's lovely," said Bob Champagne, a Navy veteran who participated in the blockade of Cuba during the 1962 missile crisis. "It's not a prison."

Indeed, Champagne said, he recently left the home to attend a Mark Twain impersonation in this small central Massachusetts city.

But, during a recent visit to the home, Gerard "Skip" Pilkington, a Vietnam combat veteran from Malden, was in another room, shaking from the effects of his 17th bout with chemotherapy for cancer that has invaded his prostate, lymph nodes, ribs, and spine.

"I'm still a young guy," said Pilkington, 62. "I want to see my grandkids grow up a little bit more."

Pilkington, who had lived alone in a Connecticut apartment, said he moved to the hospice for companionship.

"I try to keep plugging along," he said, a Vietnam veterans cap hung near his bed. "I try to take it day by day."

For Martha Gauvin, the hospice's health coordinator, the opportunity to work with veterans is profoundly rewarding.

"To be with veterans when they're dying, it's really and truly a great honor," Gauvin said.

Caring for terminally ill veterans, however, can present stubborn, difficult challenges, said Amy Tucci, vice president of programs for the nonprofit Hospice Foundation of America, which is not affiliated with the veterans home.

"There are a whole set of end-of-life issues that are unique to veterans," Tucci said. "Some of those include bringing to the experience of dying the same grit that they have had on the battlefield and the same denial of pain that they have had to endure in their lives."

Mark Helberg, one of the co founders of the New England Shelter for Homeless Veterans, said the hospice is a wonderful resource. Helberg recalled that Lightfoot, who once volunteered at the Boston shelter, would speak of a dream to create a warm, comfortable place where veterans could die with respect.

"She really hit a home run," Helberg said.

Brittany Amistadi, a nurse who joined the staff in September, said she had always envisioned maternity work as her niche. But here, in her first job since becoming a registered nurse, the satisfaction has been overwhelming, she said.

"There is something to be said, in somebody's last days and minutes, to make them feel loved," Amistadi said.

The hospice has provided shelter for 144 veterans since its opening, all but one of them men. Some of them have died here within 24 hours; others have lived at the home for years; some spend their final hours in a hospital; and others have been asked to leave for rules violations, which include not accepting treatment for substance abuse. Eight clients have died this year.

The residents are required to contribute one-third of their income toward food, but the financial resources of most of the residents are minuscule, said Tara O'Connor, the hospice's chief financial officer.

To make ends meet, the hospice receives about one-third of its funding from the US Department of Veterans Affairs, one-third from the state, and one-third from grants and philanthropy, O'Connor said. For fiscal 2005, the home had revenues of $809,021 and expenses of $886,893, according to its most recent tax return.

"The vets say: Leave no one behind," O'Connor said. "We're not going to do that here."

Brian MacQuarrie can be reached at macquarrie@globe.com.