Passages : a hospice for New York City

Abstract

At the beginning of the 20th century most Americans died at home from diseases whose onset was quick and aggressive. The average life expectancy was only 50 years. Antibiotics first appeared in the 1940's and when the baby boomers were born medicine entered an unprecedented age of transformation, one where illness could be prevented, treated and cured. Unfortunately, along with this progress have also come slower and often more painful deaths. The most common causes of death today are degenerative diseases such as cancer and heart disease. Thus, it appears that the ability to treat disease has altered medical philosophy from a platform of maintaining health to one of preventing death at almost any cost. It is into this environment that the concept of hospice care has emerged as an alternative way of thinking about death and dying, a reaction to the existing biomedical model of care. Hospice has put a humane focus on dying by creating a setting where pain is managed allowing the patient to move onto the hard work of dying, the psychological and spiritual dimension of the process. While the philosophical concept of hospice developed in the United States during the 1970's the questions surrounding the appropriate hospice environment have not yet been answered successfully This thesis attempts to give form to the notion of hospice. It attempts to create a place where dying exists within the natural processes of life and is celebrated and sanctified as such.