After retiring from the Wilcox Emergency Department after 50 years, Dr. Monty Downs wasn’t satisfied simply closing one door, he was looking to open to another.
When the opportunity to continue to help patients in the community came available, he gladly took it.
Downs has now taken on the role as Medical Director at Kaua‘i Hospice in Lihu‘e, providing much-needed end-of-life care for some of the island’s neediest residents.
“We go to people’s homes. I’m loving it. I feel like the luckiest man on earth to have found a job where I can go into people’s homes and see who they are, see their running pictures, their military pictures, see their pets, their caregivers, their children,” said Downs.
Established in 1983, Kaua‘i Hospice provides services to patients who are in need of both end-of-life care and palliative care. The staff has access to medications and equipment that help people live with a life-threatening, incurable illness; this is important in being able to provide the best and most meaningful care possible for patients. For those who need end-of-life care, it is provided at home to give patients more comfort. For a person to qualify for Medicare Hospice Benefits, a patient needs to have the medical director state that they have a life expectancy of six months or less.
“Our goals are comfort care. For us that work in hospice, it isn’t about dying, it’s about living, and about living your remaining days as happily and comfortably as possible,” Downs said. “Many times we see that for people during this imperative time, that it can be a wonderful time of life where you make connections with your children or your spouse, and your priorities change.”
Downs envisions solutions for those who do not have a place to live and struggle with serious medical illnesses.
“An amazing goal would be what is called a hospice home, which we don’t have on Kaua‘i. For a person to be able to be enrolled in Kaua‘i Hospice you have to have a caregiver around the clock at home. The reason being is that people are taking pretty significant medications so we have to have a reliable caregiver to administer the medications,” said Downs. “So, if you aren’t living at home, or are living at the beach and have a serious illness, we cannot accept you.”
He adds that hospice homes are available in many other places, and for that reason, it is a possibility in the future.
“There are hospices all over the world and the country and on other islands where there is actually a house with three or four bedrooms in it and people can live there in the facility and receive care.”
With help from a donor, though, providing a space for those without homes to receive care could be achieved. It takes much more than caring medical staff to keep a hospice home running, however.
“It would take some benevolent donor to inject millions of dollars to buy a property and house to have staff, security, cook and provide food, housekeeping, and landscaping.”
Downs explained that other medical needs can be addressed through the facility.
“We provide more than comfort care. If you are diabetic and have high blood pressure we can continue your diabetes pills and your thyroid pills,” Downs said.
He said people can receive care with the facility through other means than coverage by Medicare, such as military veterans who can use their benefits to receive care.
Downs continues on the topic of benefits and hospice misconceptions.
“You can revoke from hospice at any time that you wish if it’s not working for you. You’re not signed up forever. Also, you don’t have to have money to receive hospice care, we take pro bono patients if they don’t have medicare. You don’t have to have money or insurance to receive hospice care.”
He not only provided caring treatment at Wilcox emergency room, but also used his musical skills to comfort his patients.
When he had downtime, Downs would play guitar and harmonica in the emergency room and the COVID-19 vaccine clinic.
The doctor still plays music for his patients.
“I take my guitar to people’s homes when I can, if it’s appropriate. It’s very therapeutic for people and for me, I get to put my skills out there. There’s some patients that really really like it,” he said.
Downs and his wife donated to Wilcox, helping to pay for renovations of the exam rooms in the new emergency department. In addition to his role as a physician he also is an officer of the Kaua‘i Lifeguard Association as well as a team physician for Kapa‘a High School’s football team.
