Spatial practices and the home as hospice

The modern hospice movement emerged in the late 1960s largely as a reaction to the way in which death and dying were dealt with in the hospital building. From the early development of the hospice movement, setting was considered to be very important. Hospice buildings were more residential and "homely" than their hospital counterparts. However, with the widespread development of "hospice home-care" programmes in the 1980s, this emphasis on place and setting changed, and along with it the meaning of the term "hospice" has changed. The current claim of the hospice movement is that "hospice" is a philosophy of care not a building or place.Home is now widely considered to be the best place to die, a place of familiar surroundings and the company of family and friends. The modern preference to die at home relies on traditional models of home, family and community. Dying at home was at one time commonplace and envisioned within the design of the home, and caring was a normal expectation of key family members. In modern society, however, dying is generally not a considered function within the design brief of the home and families may be unable, through economic, geographical or other reasons, to be carers. Thus, for some, home may not be the best place to die and family may not be the best carer. As a result, many people, despite their preference for home, still end up dying in the hospital building. This paper discusses the spatial issues surrounding the concept of home as hospice and questions the universal suitability of the contemporary home as a hospice.