Hospice programs exist in a variety of settings, including health care facilities, institutions, and private homes. Access to these programs depends on a number of factors, including the availability of hospice care in a particular jurisdiction, affordability, and the condition of the patient. In some places, such as the United States, hospice care is typically provided in the home of the person who is dying. If home care is not possible, a patient may be cared for in a hospice program within a hospital, nursing home, or a freestanding hospice center. In all cases, hospice programs address the needs of terminally ill patients by helping them to manage pain and providing practical, psychological, and spiritual support to both the patient and his family members.
Individuals who are dying have significant needs that have historically been ignored by established health care practices. These needs often include effective pain management and recognition of the patient's fears. In addition, the families and friends of the dying are often in a great deal of emotional pain and may also be in need of various types of support, including relief from care-giving duties as well as counseling for managing their own fears and grief. Hospice care seeks to address these needs by providing specialized care throughout the dying process. Care is provided both by family caregivers as well as specially trained doctors, nurses, and social workers.
In many cases, a patient is provided with hospice care while remaining at home. This allows the patient to remain in a familiar place and to be cared for by family members. A hospice agency provides care through visits by physicians, nurses, and social workers as well as volunteers who can help the family by performing chores, running errands, or sitting with the patient while family members sleep or engage in other activities.
Other hospice programs provide care for those who, for whatever reason, are unable to be cared for or die at home. For example, some people do not have a family member who can act as a primary caretaker, and so they must be cared for in a hospital or nursing home. In other situations, a person may already be confined to an institution outside the home, such as a mental hospital or prison. In such cases, hospice programs work with the institution to provide hospice services to those in their care.
Another type of hospice service is the freestanding hospice. This is a dedicated facility that provides hospice care to patients who are near death but who cannot be cared for at home. These centers do not exist in every community, but they can provide an alternative for people who prefer to remain out of the hospital or a conventional nursing home as they die.