A hospice pioneer reminisces about bringing services to Cape Cod

Mary McCarthy, the founder of hospice services on Cape Cod in the early 1980s, is now enjoying retirement, and has some positive thoughts on aging.

“Despite its challenges, growing older is exciting because the world keeps changing around us, and we get to witness it,” she said. “Certain memories and moments stay with us, and even as our bodies change, we are still who we are.”

McCarthy, 87, is the founder of the former Hospice of Cape Cod, which is now the Visiting Nurse Association (VNA) of Cape Cod Hospice & Palliative Care. I caught up with her one chilly spring morning at her daughter’s home in Barnstable, not far from the original Hospice House on Railroad Avenue.

The warm welcome I received from her as she stepped outside to greet me, was matched by the glow of the crackling fire in the woodstove of her colonial-style kitchen, where we sat and talked. The last time I had seen her was in the late 1990s when I was on the staff of the Barnstable hospice house. Working there was one of the most meaningful experiences I’ve had in my 54-year nursing career. We reminisced a bit about the compassionate and personal care we provided to terminally ill patients and their families, which, in the beginning, took place in their own homes.

Following England’s Lead

McCarthy founded the organization in 1981 based on the hospice program in England. She was hired by a board of directors, even though there was no funding to support the program and she would need to do all the fundraising.

While she had experience caring for terminally ill patients during her nursing career and during the five years as the assistant director of nursing at Falmouth Hospital, she had no experience working in the community.

“Florence Ungerman, who lived in Centerville, donated $100,000 to the hospice organization, and with that donation, we got started,” said McCarthy. “I was doing everything from providing care to new patients, creating a volunteer training program, meeting with people to talk about hospice and interviewing potential volunteers for staff and nursing.”

She created a hospice team comprised of nurses, Cape Cod Hospital oncologist Henry Casey, MD; a social worker; and a chaplain to meet the physical and medical needs as well as the emotional and spiritual.

“In the beginning, there really was no guidance in the United States on how to set up a hospice program, but the guidance of the English hospice helped,” said McCarthy. “There was no health insurance that covered hospice care, so we built the organization on donations.”

Meeting a Need

“As soon as I started seeing patients in their homes, I knew we would need a facility for those without family support or a 24-hour caregiver,” McCarthy said.

In 1993, Hospice House opened, providing patients with a place to go to live their final days in a peaceful and compassionate environment. The house featured seven bedrooms, each with space for a loved one to stay with the patient, along with a comfortable living room for visitors. On the second floor, there was a kitchen run by a wonderful cook who prepared both a regular menu and special meals requested by patients and their families.

“Anyone could be admitted to Hospice House, regardless of their ability to pay,” McCarthy said. “It was a safe haven where they could stay until the end of their life.”

A second hospice facility that opened in Sandwich in 2002 is named after McCarthy. It was originally called the Mary McCarthy Hospice House and is currently known as the McCarthy Care Center. It is larger than the original Barnstable house and has 10 bedrooms with decks that look out over gardens and trees.

“This house was constructed so patients in the east-side bedrooms can watch the sunrise, those in the central rooms could follow the sun’s path throughout the day, and patients on the west end could watch the sunset,” said McCarthy. “My son, Paul, suggested designing the main entrance so that, upon entering, you can see straight through the living room to the outdoors. This house was designed intentionally with these ideas in mind.”

Changes for Hospice Care

There have been many changes in hospice care over the years, including Medicare providing a hospice benefit to cover hospice care, which didn’t exist when McCarthy started the Cape Cod program.

The Barnstable Hospice House closed in 2003, in part due to financial challenges of increased healthcare costs, along with declining patient admissions.

Admissions to the McCarthy Care Center are now temporary short-term stays for symptom and pain management.

Many Memories

McCarthy has many fond memories of her time with Hospice of Cape Cod.

“The Cape Cod Community embraced us,” she said. “They helped fund it, became volunteers and we created a wonderful staff that included a volunteer coordinator and volunteer chaplain.”

The program she is most proud of was the “Kids Grieve, Too,” program that her daughter, Susan Kerr, a social worker, started to help children who experienced loss. Children were given a safe place to share their feelings and receive support.