There’s a gentleness, compassion in her voice when Alane Capen recalls making wishes come true for men and women -- even a teen-age girl -- who were in hospice care.
The retiring President of Coastal Hospice in Salisbury, who has been praised for her many achievements, was pleased to be involved when a patient who was an artist had a dream of having a show of her works. Staff planned it and the artist was there, content, fulfilled, using oxygen to help her breathe but gladly signing prints.
“She was thrilled,” Capen said.
Other times, a couple wanted to celebrate one more anniversary and the daughter of a woman who was dying asked to get married in her mother’s presence. Hospice staff planned nuptials in her home.
“The chaplain performed the wedding. It’s important finding those individual life-meaning goals beyond symptom management,” Capen said, remembering a teenaged patient who knew she wouldn’t be able to attend her high school prom.
“She wanted some type of party with a fancy dress. We went to our thrift shop and got a bunch of them. She chose the one she wanted and her family got involved in having a party and a nice dinner. It’s our mission to provide dignity and comfort to those facing life-limited illnesses. That is the most important thing. A team approach is at the center of every plan for the patient and their family. We are trying to ascertain what the patient’s goal is. For some, it may be about pain relief but for other people, we have helped them achieve different goals,” she said during a recent conversation.
Capen came to Salisbury from Texas. Her husband, Ralph, was looking for a new job and had an opportunity on the Eastern Shore. Capen was working in the hospice field in Texas and said she began communicating with Coastal Hospice in Salisbury. In August 2005, she was hired as Vice President of Clinical Services. Three years later, Coastal Hospice’s first president, Marian Keenan, retired, and the Board of Directors named Capen to succeed her.
The 64-year-old, who has no children with her husband, but has two stepchildren and seven granddaughters, was drawn to hospice work “way back when I was in nursing school, when my own mother became ill with cancer and passed away.”
Her mother, Ruth Keeman, died in 1982. Her father, Robert, died while with her in her native Massachusetts. “We had hospice for him, but it was too short, like it is for many patients,” she said.
“My career was in oncology. I ended up working with cancer patients and saw many examples of both the good and not-so-good end-of-life experiences, so I had kind of heard about hospice and kind of started to explore it and decided that’s what I wanted to do. Now, I’ve been in the hospice field since 1986,” she said.
After being a hospice nurse for a few years, she was promoted to team leader. She returned to school, earned a degree in Business and Human Relations and was certified as a hospice palliative nurse, a certification she kept throughout her career.
From team leader, she was promoted to Director of Hospice for the Visiting Nurses Association in North Texas, where she worked 11 years as Hospice Director before moving to Salisbury.
As president, her successes, as well as her duties, are many.
“Oh my goodness. What aren’t my duties?” she said with a light laugh.
“I think leading the team of people I work with -- a great team of senior leaders and a great Board of Directors – and to help guide and create the policies that then the leadership needs to implement and carry out to keep our staff doing the best care they can do for patients,” she said.
Because of her nursing background, she has always been involved in clinical policies as well, including oversight of processes in hospice, oversight that she has recently handed over of multiple committees and departments that report to her, striving to provide tools they need from senior leadership and making sure it translates down to staff and what they need to care for patients.
She developed the first residential hospice on the Lower Shore, created Coastal Compass, a free program to connect patients not yet under hospice care to services such as food and transportation as soon as they are diagnosed with a life-limiting illness and a partnership with TidalHealth to bring palliative care to patients’ homes.
When she took over as president, there were no Admissions or Marketing departments, and she started both of them.
With a $15 million annual budget, Coastal Hospice employs more than 180 people, both full time and part time, and serves Wicomico, Worcester, Somerset and Dorchester counties. There is one full-time doctor, one part-time and others on call, as well as nurse practitioners.
When she arrived, there was an average of 50 or 60 patients, but now there are about 200, and there were more before the coronavirus.
She also developed the first grant and statement of need for the Compass Program, which provides support and connects clients to community resources.
Capen is particularly proud of the Macky & Pam Stansell House in Ocean Pines, a project she worked on for 10 years, with a 2008 needs assessment that businessman and local philanthropist Stansell funded.
In 2010, Capen and former-Development Director Maureen McNeill traveled with hospice architect Tom Mullinax to look for property. She worked with Director of Facilities, Kevin Ireland, and Salisbury University student Matthew Stohr, on the business plan and the opening of the Thrift Shop to benefit the Stansell House in 2011. The following year, Farmer’s Bank of Willards offered the property and it opened in 2019.
“We are very happy with it. It is a licensed hospice house, a residence facility, unlike Coastal Hospice at the Lake, which is a patient facility for the more acutely ill.
“People whose symptoms are well managed, but who need a safe place to live go to Ocean Pines, maybe someone with an elderly spouse. The two of them might be alone and there is nobody who can take care of them. It’s a private pay facility. We hope they will be there for a while. We do have people who pass away there,” she said, explaining if symptoms are reasonably managed they can stay there, but are better served at Coastal Hospice At The Lake if they need full-time medical care.
“Watching people at Stansell House today is a phenomenal experience,” Capen said. “Together we achieved so much. Even during Covid-19, when almost no one could have visitors, we managed to keep people visiting safely at Stansell House and The Lake. I am so very proud of our staff for that and for so many things. Every staff member in their own way makes an amazing difference, whether they are in front of patients or working in other ways; each role is essential to our mission of providing dignity and comfort,” she said.
Most hospice patients – about 180 currently -- remain in their homes.
“That is most of what we do. Often people come to us very late. They don’t realize the kind of help they can get. They think, ‘Do I have to be in pain to be in hospice?’ No. If someone calls somebody at 2 a.m. we have staff and that is their shift. They will come any time of day or night and address the issue you are having. People are often referred when they only have a short time left. We do our best work when we have time with the patients, so volunteers can form a friendship and the chaplain can establish a relationship. The patient might have questions like, ‘How can I talk to my grandchild?’ or ‘I haven’t talked to my brother in 15 years.’ Those are the kinds of questions people might have. It’s better if we’re in there earlier rather than later,” she said.
Successor in place
Capen is being succeeded by Monica Escalante, who joined the Coastal Hospice staff in mid-July, coming from Montgomery Hospice in Prince George’s County where she worked around 20 years.
“Monica brings so much to the table. Her knowledge of the non-profit hospice world is second to none. Her experience, her ‘hospice heart’ and her detailed plans for how she will help Coastal Hospice grow and thrive in the years ahead made her a strong choice. We all look forward to working with, and learning from, Monica and we welcome her to the Shore,” said Mike Dunn, Past President of the Coastal Hospice Board and Chairman of the Search Committee.
Escalante is one of the first Latina presidents of a hospice.
At Montgomery Hospice, where there are 340 employees, more than 300 volunteers and an in-patient unit with 14 beds, Escalante was hired as Director of Volunteer Services in 2002, named Chief Communications Officer/Business Development in 2007 and Chief Financial Officer in 2010. She supervised Intake/Admissions from 2007 to 2019.
She is fluent in English and Spanish and conversational in Portuguese and has a master’s degree in Public Policy & Management from Catholic University of La Paz and Harvard University La Paz and a master’s degree in Marketing from Johns Hopkins University.
Capen praised Escalante’s talents, abilities and energy and said in her retirement she and her husband are traveling to Europe and she will have time to spend with their horses. In time, she might volunteer for local organizations.
“This is a job people don’t do because it’s a paycheck. People figure out very quickly if this is the line of work they really want to do. It takes about two months of an employee working here and really getting the sense, because it is hard. You lose patients. You see families who are grieving and who are stressed. That’s what you are going into every day and what you are trying to alleviate every day. Most people come through it with a personal experience. It was my mother’s death that led me to oncology and then it was oncology that led me to want to see good end-of-life stories,” Capen said.
“If I can make a family feel more at ease or make that patient not have that pain or not have that nausea any more, then I can go home and feel good. They are dying whether I am there to help them or not. I can feel good if I have done something to alleviate their pain. But you have to find your own self-care. You have to play as hard as you work and you have to find joy in life.
“It’s about finding moments in life to still celebrate. It may be as simple as looking through a photo album with family and validating good memories or as complicated as pulling together a wedding.”