Exploring the Ethical Dimensions of Hospice Care in Nursing Homes
Each year in the United States approximately a quarter to a third of the deaths of older adults occur in nursing homes (US Census Bureau, 2010). These statistics indicate that nursing homes are vitally important in providing end-of-life care to our oldest frail adults in their final days. Hospice care is seen as the gold standard of end-of-life care in many settings, and studies support its benefits for nursing home residents as well. Available evidence suggests, however, that many nursing homes are not meeting even basic needs of their residents or expectations of residents’ families at the end of life (Munn et al., 2006; Murphy et al., 1997). In this thesis, I will argue that the problem of poor end-of-life care for nursing home residents is rooted in a fundamental difference between the philosophies of hospice care and nursing home care. To present and defend my position, I will examine three essential questions: (1) what are the philosophies of both hospice care and nursing home care; (2) should these two philosophies of care work together, and if so, why; and (3) how should these two philosophies of care become more harmonious?
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