HOSPICES: Life-Affirming Care for the Dying.

• Author: Levy, David C.
• Position: Various artists, various museums - Brief Article

"... While hospice [care] may not be an answer for all the dying, it is of immeasurable help to many who otherwise would be in agony, despair, and need."

My generation of Americans never learned to cope very well with death. Our parents did better because they grew up in a world that recognized dying as part of living. Perhaps they were closer, in what seems to have been a simpler time, to the natural order of things. What is certain is that, for them, it was common to lose friends or loved ones by the age of puberty. Dying and grieving were part of community life, whether in city neighborhoods, small towns, or rural farmlands. Mostly, people died at home, where their families closed ranks in mutual support, helping the dying and themselves to face the unknowable.

Most of us who grew up in the aura of scientific and technological faith that has marked postwar America have had a different experience. Often, we have known our parents well into our own middle age. As children, few of us experienced the death of a friend. Polio, smallpox, and tuberculosis--fatal and commonplace in our parents' generation--have been all but banished. Most important, we have been protected, if not insulated, from the dying. Indeed, to us, the very idea of death is only marginally discussable. Rather than accept and deal with this inevitable right of passage, middle-class America made it the ultimate taboo. In 1993, Marilyn Webb, author of The Art of Dying, aptly wrote that we kept death "locked behind hospital doors." As is the usual case with incarceration, in doing so, we also reduced our chances of coming to terms with the prisoner.

Ironically, at a moment in history when technology in every discipline is expanding exponentially, we are moving back toward our parents' gentler understanding of death. We are accepting it with a new humanism as an integral, dignified part of our life process and, importantly, bringing the dying back in to our homes. The hospice movement has been a crucial component of this change in our attitudes.

A central theme of hospice is the belief that the terminally ill should be relieved of pain and, wherever possible...