The sign nailed to the banyan tree read: “Hospice Advocates: Meet Here.” The year was 1977. Most people didnt even know what hospice meant. But in South Florida there were a few who knew. They met under that banyan tree and started a process that would change the way people throughout the country looked at death and dying.
Esther Colliflower and Hugh Westbrook were two of the group under the banyan tree that day. Esther was an RN who had raised eight children and re-entered the work force in the early 1970s as a professor at Miami-Dade Community College. Hugh, a Methodist minister and community activist, taught at the same college.
Esther and Hugh were inspired by a new national debate, provoked by Elisabeth Kubler-Ross and her groundbreaking work, “On Death and Dying,” which encouraged caregivers to discuss death with their patients.
The banyan tree under which the VITAS founders first assembled in ad-hoc style to discuss the need for and community interest in hospice care in Miami, Florida.
Esther and Hugh believed that terminal illness shouldnt be the end of the discussion; it should be the beginning. They developed a course called “Life Affirmation and Death Attitudes,” a timely topic that drew like-minded professionals.
In 1977, the Dade County Mental Health Association held a conference on Fisher Island on caring for the dying. Hugh and Esther attended, and met others interested in developing a hospice program; an impromptu meeting was called under a banyan tree on the property. In South Florida, the hospice movementand what would become VITAS Innovative Hospice Care®–had begun.
Hugh and Esther continued to meet in more traditional places for a year before starting Hospice of Miami. Esther was the first staff member unpaid. The first patient would complete the trilogy Hugh, Esther, Emmy that is revered in VITAS history.
As Hugh told it at the companys 20th anniversary in 1998, “Emmy Philhour had annoyed her doctor enough that I think he was happy to refer her to us. This pesky, opinionated woman who didnt want any more chemotherapy and these pesky hospice people who were looking for a patient made a perfect team.
“Emmy was determined to die at home without pain. She told us, I know you dont know what youre doing. But if you help me die at home, Ill teach you how to do it. She was a brave, wonderful woman who essentially taught us the team approach of care that we use today.”
As the largest hospice provider in the nation, VITAS has influenced the way U.S. healthcare addresses death and dying. Hugh and another VITAS founder, Don Gaetz, helped pass the Hospice Care Reimbursement Act in 1982 that made hospice a Medicare benefit. Since then, 10 million Medicare, Medicaid and private insurance beneficiariesand people with no medical insurance at all– have received the compassionate care Hugh and Esther had in mind.
A 30-year-old photo hangs in a place of honor at the Miami headquarters of VITAS Innovative Hospice Care®. It is of that banyan tree, sign and all. Hugh and Esther retired in 2004 when Chemed Corporation bought their company. But VITAS is still committed to responding to individual end-of-life needs and wishes.
Maureen Knips, general manager of VITAS Broward County program, has been with VITAS since 1986. She has experienced the progress the company has made since its inception.
“I joined before we had dedicated teams,” says Maureen, who started as a nurse when the Broward County program had 60 patients. “We would visit patients in nursing homes and their own homes. Wed work all day, then at night we might be on call or triage. If your patient died at night, you went back.”
The Broward program now cares for 1,300 patients each day. VITAS also has programs in Palm Beach and Miami-Dade and Monroe counties. It also provides its services through 40 other programs in 15 states and Washington, D.C.
Maureen says its amazing how many things havent changed. “Were so much larger now but VITAS still feels like a family. Esther and Hugh wanted people to enjoy coming to work. That approach has withstood the test of time.”
