Because of physical and mental health conditions, an estimated 9.5 million persons in the United States have difficulty performing routine activities essential to living (Home-health and hospice care, 1993, pp. 820-824). An increasing range of home-care and hospice services are being made available to these people.
In contemporary society, a hospice provides a group of interlocking services for care of the dying (Dawson, 1991, pp. 83-87). The aim is to help them die peacefully without actively prolonging life or accelerating death. As most terminally ill persons prefer to live in their customary ways so long as is possible, the heart of the hospice is home-like care. Programs of this type for the terminally ill permit the individual to remain at home as long as is possible, before being admitted to a hospice, which in so far as is possible provides care in a home-like, as opposed to a hospital, environment. The most recent innovation in hospice care is the creation of a hospice environment within the patient's own home (Rhymes, 1991, pp. 803-816).
Hospices are of three major types. The free standing hospice is independent of any acute care hospital, while the institutional hospice is an independent facility within an acute care institution, and the hospice in the home is created with the homes of patients (Rhymes, 1991, pp. 803-816). Advocates of the institutional hospice note that in a hospital-based hospice curative treatment as well as physical therapy is readily available when warranted. Supporters of free standing hospices maintain that putting terminally ill patients in acute care hospitals where they know that most other patients will recover demoralizes them. The hospice in the home permits patients and their family care givers to remain in control of the dying process as long as possible. Further, most dying patients prefer to remain in their own homes.
The majority of hospitals in the United States admi...