concentrate on those patients who have difficulty in communicating because of dysphasia or dysarthria, who are unable to accept what is happening to them, and those whose families need support. We admit as many patients for emotional and spiritual care as for physical care, which is often the easy part.
I see the gathering of expertise to deal with complicated physical, emotional and spiritual problems as one of the roles of the in-patient hospice and the passing of this expertise to others in training. For the same reason, because one is able to collect in one place complicated problems, research should be stimulated and funding found to support it, to look for solutions to these problematic areas of care.
Conclusion
In summary, in-patient hospices are more than places for patients to spend their last days. The role of in-patient hospices is changing. They have become the places for dealing with the more complicated conditions in palliative care, and places in which to pass on the knowledge in the training of others in the specialty of palliative care. They are also the places to acquire new knowledge in the care of the dying by means of research. They have to look into their role as a base for hospice home care and day care programmes to enhance the options open to patients. They have to look into coverage of conditions other than cancer, such as AIDS and the more common non-cancerous problems that our populations die of.
