ABSTRACT
Whilst having devoted my life to hospital work, I have come to the conclusion that hospitals are not the best places for sick people except perhaps for a few surgical cases.
Florence Nightingale, Chicago 1893
Since the 1950s there has been a developing trend towards the hospitalization of death. Studies based on random samples of deaths that had a recognized terminal period showed that the proportions of patients in England who died in institutions increased between 1969 and 1987 from 46 per cent to 50 per cent (hospitals) and from 5 per cent to 18 per cent (hospices and other institutions). Meanwhile the proportion of those who died at home reduced from 42 per cent to 24 per cent. However, despite these trends, patients spend 80-90 per cent of their last year of life at home.1
