Sanctum, a new 10-bed hospice and therapy home for some of Saskatoon’s most vulnerable persons, plans to open its doors near St. Paul’s Hospital at the end of October 2015.The newly formed non-governmental organization made up of interagency professionals has been created for people living with HIV who require specialized assistance in managing their symptoms due to homelessness, poverty, addictions and/or mental health issues. The initiative is being supported by Saskatoon Health Region’s 90 Days of Innovation: Ready Every Day Community Strategies team.

“We are pleased to partner with our new community-based partners at Sanctum,” says Corey Miller, team lead. “The HIV hospice and therapy home will allow us to transition care for these patients into a more appropriate setting in the community.”

Part of Sanctum’s mission is to help people, so they can live with HIV rather than die of AIDS.

“In Canada, people should not be dying of AIDS,” says Dr. Morris Markentin, president and co-founder of Sanctum. “New medications for HIV are so good that people who are diagnosed have the potential to live a normal lifespan.”

However, this is not the case for many HIV-positive individuals who are also homeless in North America.

As many as 75 per cent of homeless people  who are also HIV-positive will die within five years of being diagnosed because they do not have access to the support they need, says Katelyn Roberts, vice president and co-founder of Sanctum and a social worker with Saskatoon Health Region.

“This population needs more than just treatment of their HIV,” says Roberts. “They need access to housing supports, mental health and addiction outreach services, connection with detox services and methadone assisted recovery, spiritual care, cultural support, peer support and daily programming to help build their independence and life skills. Sanctum will allow us to utilize services that already exist in the community that our clients cannot currently access because they are homeless.”

One common diagnosis for HIV positive patients with addictions is endocarditis, a bacterial infection around the heart that often requires six weeks of IV antibiotic treatment.

“Patients with housing can often receive their medication through home IV therapy as an outpatient after their first week in hospital, but those without stable housing, who also have ongoing addictions and mental health issues, cannot. They often discharge themselves against medical advice before completing their medication, leading to more severe complications. They then enter a cycle of emergency care and hospital re-admissions.”

A medically-supported home environment like the Sanctum hospice will allow patients to complete their treatment and optimize their recovery.

“The vision of Sanctum is to help clients obtain an optimum level of health from their perspective in an environment that is non-judgmental, without prejudice and in line with Sanctum’s core values of compassion, collaboration and innovation,” says Roberts. “The hospice will not only provide a safe place for our clients to be treated but also for healthcare workers to treat them.”

Sanctum will offer three types of care: supportive, palliative and respite.

A total of seven beds, available for up to three months per patient, have been allocated for clients who require supportive, sub-acute or rehabilitative care when they have been diagnosed with AIDS, their level of care does not meet long-term care qualifications, or they cannot access home care support due to their current housing situation.

Clients with terminal AIDS or an AIDS-related illness will be admitted as a priority to two additional palliative care beds. The last bed is dedicated to respite care clients who need a place to stay for up to 14 days while recovering from an operation or waiting for appropriate supports.

Sanctum is expected to reduce healthcare spending by more than $800,000 annually after accounting for operational costs, by reducing HIV patient visits to the emergency department by 40 per cent (approximately 200 visits) and reducing inpatient bed utilization by 2,902 days, freeing up an average of eight hospital beds per year.

“It’s about getting the right patient, the right care, in the right bed,” says Miller. “By treating these patients in a community setting rather than in hospital, the healthcare team at Sanctum will provide holistic care to treat clients’ drug addiction and the root causes of this addiction, in addition to their HIV symptoms.”

Sanctum will also have a direct benefit on the community.

“When people living with HIV take their medications regularly, they reduce their viral load (the amount of virus in their bloodstream), which virtually eliminates their risk of spreading disease,” says Dr. Markentin. “This in turn creates a safer community for both these clients and the general population as a whole.”

Saskatchewan is one of the last Canadian provinces to open an HIV hospice, even though it has one of the highest rates of HIV positive individuals in the country. This is primarily due to the high rate of intravenous drug use, which accounted for 77 per cent of new HIV cases in 2009.

In the video below, Katelyn Roberts, vice president and co-founder of Sanctum and a social worker with Saskatoon Health Region, talks about the importance of Sanctum.