Death doula plans alternative hospice in Inver Grove Heights house. The city has questions.

Christin Ament has big ambitions for the spacious house surrounded by aspen and oak trees in Inver Grove Heights.

It’s where Ament, a former Mayo Clinic nurse, hopes to welcome three dying people at a time to pass their final days. Instead of fluorescent lighting and severe hospital furniture, there will be sun-drenched rooms and tea ceremonies, huge windows and jars of herbs.

Volunteers will serenade them, read to them, braid their hair. Trails and gardens will allow grieving families to process their loss on the expansive property that constitutes what’s she’s calling The Bardo, a reference to a Tibetan Buddhist concept for the liminal space between life and death.

But before Ament can do any of that, she has to get the city on board. And some Inver Grove Heights officials have raised concerns about greenlighting a hospice model so new that the state Department of Health doesn’t yet license it.

“I’m not saying anything bad will happen,” Council Member Sue Gliva said at a recent meeting. “But it just seems like a big risk to the city to have something without some kind of monitoring.”

For the City Council, Ament has framed The Bardo as a badly needed service for the city’s aging population amid a dire caregiver shortage. The months of back-and-forth have left Ament, the executive director, and her two staff members “bleeding money.”

Elected officials will vote Feb. 24 on whether to allow the Bardo to operate in an estate residential zoning district — and depending on the outcome, heralding or hampering its launch.

“If this doesn’t go through, we’ll have to stop,” said Ament, a death doula who provides comfort to people in their final days. “And what a tragedy.”

Ament, a nurse practitioner, spent six years as a staff nurse in Mayo Clinic’s neurointensive care unit. The experience was incredible, she said, but left her uneasy with certain aspects of how hospitals handle death, especially the focus on a patient’s illness rather than their “whole person.”

“That just didn’t sit well with me,” she said.

A few years of hospice work, plus a seven-month trip across Asia to study Chinese, Tibetan and Ayurvedic medicine, helped Ament formulate the Bardo’s approach:

“The Bardo seeks to really throw the whole idea of what it is to die in America wide open and say, ‘What else can we do?’” said Ament, who quit her job as a community-based palliative caregiver to open the facility. “How can we make it more beautiful?”

Every patient must be enrolled in a hospice agency that can manage their medical care. Ament noted that providers with such agencies typically visit people only a handful of times a week, leaving dozens of empty hours that Bardo staff and volunteers intend to fill.

Their presence will relieve family members otherwise forced to take off work or pay private health aides, a service Medicare rarely covers, to keep watch over a relative, Ament added.

She hopes to fund The Bardo through donations — the nonprofit received an initial cash infusion of $1.8 million — while also asking families to contribute what they can. The average cost of a stay is $350 a day, she said, with people expected to reside there for two weeks or less.

The Bardo’s hard-to-categorize approach — Ament contends it will be the first such model in Minnesota — has generated a flurry of questions from elected officials about oversight.

The level of care proposed doesn’t meet the state’s licensure qualifications for a hospice program, a state Department of Health spokesman said.

Jason Ziemer, Inver Grove Heights community development director, said council’s upcoming vote concerns zoning alone — not whether it’s proper for The Bardo to operate without a license.

Still, its lack of official credentialing has concerned some council members and community members.

Inver Grove Heights resident Kelly Kayser said at a recent meeting that there’s a need for “compassionate” end-of-life options. But she questioned what guardrails will exist to ensure patients at The Bardo receive quality care.

“People facing death are often emotionally, physically or financially vulnerable,” Kayser said.

Ament said there will be plenty of protections.

To her, The Bardo doesn’t need a license because staff and volunteers don’t plan to offer medical care, but rather closely communicate with hospice agencies to uphold their care plans.

Outside hospice agencies will routinely visit, and family members unsatisfied with their experience can easily leave a negative review online, she said, subjecting the model to scrutiny. Ament added she would obtain a license without hesitation should the state introduce one that fits her approach.

She also disputes the assertion from some council members that The Bardo, a business tucked a few hundred feet from a main road, would mar the surrounding neighborhood.

“It’s not like we’re throwing rock concerts,” she said. “It’s quiet, it’s low foot traffic and it’s a beautiful service.”

Council Member Mary T’Kach, who endorses Ament’s idea, praised The Bardo’s goal of supporting families for a year after a relative dies, offering them wide-ranging services that Ament said could include grief groups, sauna sessions and tea ceremonies.

She compared The Bardo’s embrace of death to a joyful celebration, such as a wedding, that people might reminisce about for years.

“It’s the same thing to be able to do that [for a death] in a really warm and nurturing space,” T’Kach said.

While The Bardo could bring a novel approach to end-of-life care in Minnesota, plenty of similar homes exist across the country. Many, including Ament’s, are part of the Omega Home Network, a national group that supports home-based end-of-life facilities in roughly 30 states.

Executive Director Kelley Scott said members of the Omega Home Network have occasionally run into resistance from local governments and communities. Scott recalled her own efforts to create a similar project in Oklahoma over two decades ago.

Pushback from the neighborhood was so intense, with some fearing the facility could increase crime and worsen traffic, that she ended up settling on another spot.

“I think this all goes toward the fear of death we have in our society,” she said, later adding: “There’s still a lot of people out there that don’t want to see death in their own community.”