ON my first ever hospice visit, at the mother of all hospices, in London in 1977, my late wife and I were told about the ideal hospice death. Dr. Thomas West, medical director of St. Christopher's Hospice, drew "charts" on a piece of paper. Msgr. Kekumano’s
death in a hospiceOn the first one, the line representing the patient's condition in his or her final weeks, ran steadily downhill to a bottom line, representing death. This is a common case.
The ideal hospice quality of life line stayed at a fairly high plateau until just before the end, then dropped down sharply to the line representing death.
We have just had a fine example of the ideal hospice death in the passing of Monsignor Charles Kekumano at the St. Francis Hospice residence facility in Nuuanu Valley a week ago yesterday. A victim of prostate cancer, he passed away comfortably and peacefully nine days after being transferred there from Kaiser Hospital, where he had spent three days.
As late as the day before he died he was able to enjoy the visit of friends, including several Hawaiian musical groups. He asked for songs written by Queen Liliuokalani and bantered with perhaps his best-of-all friends, Gladys Brandt. He was 78. She is 92.
They had done many things together to help Hawaiians and the community generally. They are co-authors of the "Broken Trust" report that already has shaken up the Kamehameha Schools/Bishop Estate and the politically loaded method of choosing its trustees.
It was my good fortune to call on the monsignor early Saturday afternoon, less than 45 hours before he died. I got no inkling death was so close. He was at a 45-degree angle in a hospital bed, peaceful and comfortable. I praised his whole career and particularly his "Broken Trust" contribution.
He was vigorous in saying a reform had been started that cannot be reversed -- and proud. We even talked about a time when he was Honolulu City Charter Commission chairman and sailed into me publicly for something I wrote. He always stood up for what he believed in, he said. And, of course, he did.
He lived alone in a downtown apartment until this month. The last time he drove a car was in December when he came to the Star-Bulletin to pose with the other "Broken Trust" authors. Using a cane, he stood for one photo, but had to sit for a later one.
On Jan. 4 he taxied to the home of another "Broken Trust" author, Randall W. Roth, for a dinner of the five authors with the Roth family. The monsignor still showed his sharp wit and was a vigorous contributor to the conversations, Roth said.
On Jan. 17, the hospice team told Brandt he had begun to slip seriously. She organized friends to see that from then on someone would always be at his bedside. She was among them on the final morning when he died.
He was in a coma and not talking. But the hospice team, for whom Brandt has tremendous praise, told them to converse freely, that he probably was hearing them. He seemed very much at peace, she said. He had a slight smile.
I serve on Governor Cayetano's Blue Ribbon Panel on Living and Dying with Dignity. Our most far-reaching recommendation will be that over 5,000 of the 8,000 people who die in Hawaii each year could be helped by hospice care at the end -- more than three times the number now. Not all deaths can match the ideal as closely as Monsignor Kekumano's but Hawaii already has thousands of families who can testify that hospice care, often at home, was a great help when they most needed it.
Bishop Estate Archive