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In April 2023, Joe Sergeant was a seemingly healthy 63-year-old who had recently returned to his Montville, New Jersey, hometown after a hiking trip to Arizona. Experiencing excruciating pain at work, he was rushed to the hospital, underwent emergency surgery and was diagnosed with stage 4 colon cancer.

Over the ensuing 15 months, says his wife, Nancy Sergeant, he was on a rollercoaster of medical appointments, tests, cancer treatment, news that the cancer was undetectable, and a surgery last May that revealed widespread cancer that could not be detected by technology or blood tests.

During that surgery, the surgeon removed much of his small intestine to bring him some physical comfort. Doctors said he had a few days to less than three months to live.

Healing from surgery, with four drainage points on his abdomen including an ostomy bag, Joe's condition was fragile, and he would need to be discharged from the hospital to a medical hospice, a social worker told Joe and Nancy.

Nancy began scouting out recommended hospices immediately. She says as she and a close friend drove up to Villa Marie Claire in Saddle River, New Jersey, "our bodies relaxed." She recounts that the tree-lined entry drive, the lush expanse of the grounds, and the horses grazing on the property's fields all brought a needed calm. Approaching the homelike entrance of the residential hospice after parking the car — "every step we took, we knew this was the right place for Joe," she says.

Joe is among the 800 to 1,000 people who annually make Villa Marie Claire their home at the end of their lives.

Resident Medical Director Dr. Charles Vialotti says it is a priority at the Villa to not just provide top-quality medical care but also to ensure residents have beautiful surroundings, comfortable spaces, enriching activities, delectable food, supportive staff, a lot of autonomy and control, and a chance to live out their life in the way they want to, to the extent that is possible. He says the hospice's leadership "has the mindset that people deserve dignity and quality of life — especially at this stage of life."

Holistic care
The stand-alone Holy Name Medical Center of Teaneck founded the  Villa in January 2011 to address a lack of hospice options in northeastern New Jersey and surrounding areas. The facility underwent an extensive renovation that was completed in August 2023. It has 20 private rooms for residents and 12 guest rooms for visiting loved ones.

Vialotti and the Villa's nursing staff provide around-the-clock medical care, especially for pain management. A team of social workers — supported by a vibrant volunteer community and local clergy — addresses residents' emotional, mental and spiritual needs. The social workers also offer counseling and support groups for residents' loved ones.

The Villa also serves people who are receiving home hospice care locally. They can stay on an intermittent basis at the Villa so their caregivers can get respite.

Medicare and many private insurers provide a hospice benefit for people whose life expectancy is six months or less. The insurers recertify patients' eligibility for hospice care every 90 days for two recertifications and then every 30 days thereafter. Patients who continue to decline medically can be recertified. Those who are ineligible for the room and board hospice benefit can pay out of pocket at the Villa.

Life-affirming
Vialotti says every aspect of the Villa — from the campus' aesthetics, to the culture, to the menu of services and programming, to the training and competencies of the staff — is rooted in the facility's mission. Providing every resident with a "sanctuary where every day is lived with dignity, comfort and love," is the Villa's purpose, says its website.

But this mission is not just words on a page, says Vialotti. It is manifested in the purposeful design of the grounds and facility to have the feel of an elegant yet comfortable country estate. Those grounds have easy-to-access walking trails as well as a pool, koi pond, calming water features and numerous outdoor seating areas to accommodate patients and families.

Indoors, there are more gathering spaces with modern yet warm décor, with patient and guest rooms with a feel of home, rather than an institution.

Residents and their loved ones have access to equine therapy, pet therapy, art therapy and music therapy.

Giving back control
Tracey Arnauer, director of social work, says while all those amenities are great, what really exemplifies the Villa's mission is its staff's attention to the individual. "We want to understand what is important to them, we tailor their care and focus on their quality of life," Arnauer says. "We don't focus on this being the end of life, we focus on helping them to live as fully as possible while they are here."

Upon residents' arrival, a multidisciplinary team completes a full assessment with them and their loved ones and then builds out a medical plan. That team also helps residents access the services and programming that will help them live their life more fully.

The Villa's chef prepares food tailored to the residents and their families, including honoring particular ethnic tastes. Vialotti attests that the food quality is at the level of fine dining. Residents can eat when they wish — there are no rigid schedules at the Villa, he says, noting that a goal is to give residents as much control of their lives as possible at a time when their medical condition can make them feel like they have no control.

The social workers and volunteers help the residents with "legacy projects," including videos and letters for family members. Those team members also help fulfill residents' wishes. Staff arranged for a Holy Name doctor who also is a racecar driver to give a 23-year-old resident who was a racing enthusiast a thrill ride one day before the resident died. The Villa has hosted anniversary parties, weddings, baby gender reveals and other celebrations to fulfill the wishes of residents and their loved ones.

"We get to know the residents and their families. We want them to feel seen and heard and we make every effort to help them live out their lives, the way they want, while they are here," says Arnauer.

Rising Phoenix
Nancy Sergeant says the Villa staff more than accomplished these goals for Joe, her, their son, Nick, and those who visited during the about 50 days Joe lived at the residential hospice before his death.

"This place is one of a kind — because of the love of everyone in there" and the exceptional medical care, Nancy says.

She says the Villa took the time to understand that what was important to Joe was being with family and friends. The Villa welcomed these loved ones, with the chef providing delicious meals for everyone.

When a young niece was apprehensive about visiting Joe in a hospice home, her parents brought her to the Villa on a Saturday when she could first stop by the horse stable. Informal equine therapy gave her the solace she needed to then make her way to see her uncle.

Aware that Joe regretted he was never able to get a tattoo he designed after he was told the cancer was gone, the Villa staff arranged for a Henna artist to come to his bedside and beautifully write on his forearm, "A Phoenix will rise, but the ashes come first." Nancy says Joe was delighted with this tattoo.

She says the Villa staff became friends of hers and of other family members.

She says that witnessing the care with which the staff tended to her husband enabled her to turn her focus from his medical needs to "just being his wife."

She recalls nights curled up alongside his bed in a cot, both of them gazing out the picture window of his Villa room at the stars. The two would talk well into the night about all they had shared and their hopes and dreams.

She says, "We had this chapter that was the most difficult in our 44-year relationship, but it is a time that I will remember with love forever, and that is only because of the Villa and their mission.

"My hope is that every hospice would have this mission."