Hospice care: A new American way of death?

(MCT) ORANGE COUNTY, Calif. — The elderly man, when he was young and strong, had been a photographer. He told Jerry Peay about it.

Then he just wanted Peay to hold his hand.

"Are you scared?"

"No. But I am going to die soon."

Then, slowly, he squeezed her hand.

Peay doesn't remember the man's name. She has worked at hospices for two decades, and has worked with so many patients that specifics — even about something as intimate as a man's last days — aren't easy to recall.

But she does remember the man's face, and the way he held her hand.

These days, Peay is coordinator of volunteer services for Companion Hospice in Orange, Calif., in charge of the people who, for no money, help the dying and their families.

And Peay's industry is booming. This year, about 1.4 million Americans will receive hospice care, and hospice experts say that number is expected to double by 2020.

One reason behind that prediction is need. America's baby boomers are aging and increasing the demand for end-of-life care, says Judi Lund Person, vice president for Regulatory and State Leadership at the National Hospice and Palliative Care Organization (NHPCO).

But there is another, unexpected, reason, say Lund Person and others.

Hospices are popular.

And as a result they are changing the way Americans view death.

We have countless euphemisms for the end of our lives. Laid to rest. Gone to be with God. Kick the bucket. Rarely, it seems, do we use the blunt but accurate — died.

But this wasn't always our attitude.

Once, death was played out in the community. Families took care of their dying. And few people, including children, were shielded from the harsh realities of deterioration at the end of life.

The same was true for the non-physical aspects of death. Wakes happened in houses and were often somber affairs, not the upbeat celebrations of life that have come to replace traditional mourning. Cemeteries could be found in or near the center of town.

Death, if not welcome, was at least familiar.

That changed during the second half of the last century.

From World War II until the rise of hospices, in the late 1970s, death increasingly was set apart from daily life. People died in hospitals, not bedrooms. Funerals were held in funeral parlors and houses of worship, not living rooms. Cemeteries, increasingly, were placed far away from neighborhoods.

Irvine, Calif., a master-planned city of about 180,000 that was sketched out in the early 1960s, has two preplanned hospitals, vast neighborhood and business districts and bike lanes — but no cemetery.

"We have separated ourselves from death," says Father Wayne Wilson, police chaplain at the Fountain Valley (Calif.) Police Dept., via e-mail.