Abstract
This qualitative research study was designed to explore place of death congruence among hospice patients from the subjective experiences and perspectives of hospice social workers. A semi-structured interview with nine hospice social workers served as the primary means of data collection within the present study. Using content analysis with descriptive phenomenology, dominant and underlying themes were identified, refined, and subsequently confirmed through a reliability check. From the establishment and verification of themes and sub-themes, the research questions were answered. The results of this study indicate that patients generally prefer to die in a place they call "home, " including: private residences, skilled nursing facilities, assisted living facilities, and/or residential hospice homes. This research strongly indicates that caregivers are the most critical factor in achieving a home death. Not only must caregivers be willing, available, informed, and competent, they also must have the ability to flex their roles within the family system in order to achieve a home death. Several additional factors were shown to be important determinants in actual place of death including: culture, type of terminal illness and associated symptoms, safety, and finances. Hospice social workers often act as caregiver coaches in enabling home death by maximizing caregiver strengths and by building networks of support. Hospice social workers aim to enhance place of death congruence by completing effective assessments, providing a variety of supports, educating, and providing and exploring realistic options for patients and families. The findings of the current study support previous research as well as add depth and dimension to the existing understanding of place of death congruence. The findings of the present study presented numerous implications for continued hospice social work practice. The current study offered direction for the further study of end-of-life choices in order to better provide and facilitate exceptional care for individuals with terminal illness.