The dying patient: pain management at the hospice level.

Hospice care has irrevocably changed the landscape of healthcare. First seen as an alternative to dying in the impersonal, highly technical environment of the hospital, it provides comprehensive palliative, supportive care in patient-oriented settings, usually at home or, in some instances, special hospice units. Now the challenges of hospice care largely go beyond the philosophic to include the organizational, demographic, and pragmatic difficulties of providing such care in various settings. This article discusses some of those challenges, including a number of principles and techniques gleaned particularly from the hospice experience for successful pain management in the home setting.