Striving for becoming at-home in the midst of dying

Research interviews with 12 patients at an inpatient, free-standing hospice in Sweden were analyzed, using a phenomenological hermeneutic approach, to show the effects of individual nursing care as experienced by the guests. The findings revealed that the effects of, and reactions to, nursing care were inseparable from the hospice milieu and the patients' situation, which was interpreted as including the prospect of becoming homeless. Thus, the effects of hospice spirit (nursing care and milieu) as experienced by these hospice patients represented the contrasting possibilities of hindering--or contributing to--the prospect of becoming homeless. What the patients spoke about was either a consoling or a desolating hospice spirit. A consoling hospice spirit supports experiences of wholeness and communion, i.e., becoming at-home in the midst of dying, while a desolating hospice spirit results in feelings of alienation and fragmentation, i.e., feeling homeless. Considering the dying person to be a guest rather than a patient is an important component of Swedish hospice philosophy and supports the view of the dying person as an autonomous and dignified human being.