Social Model Hospice Homes: Bridging the Gap in End-of-Life Care Delivery

J Palliat Med. 2023 Apr;26(4):503-508. doi: 10.1089/jpm.2022.0228. Epub 2022 Oct 13.


Background: People prefer to die at home, if given a choice. However, data show that less than half of hospice patients get to do so, as many lack the social resources needed for end-of-life (EOL) care to be supported at home. The Social Model Hospice Home (SMHh) is an emerging model of care and offers an option for individuals whose EOL care cannot be fully supported by their available social network. An SMHh is a community-supported home staffed with round the clock caregivers dedicated to closing this social gap in EOL care delivery. Objective: This study aimed to enhance and clarify the reasons for successful outcomes of the SMHh concept. Methods: This study used a qualitative descriptive approach. Twenty-three semistructured interviews were conducted with the participants. Located throughout North America, participants consisted of staff, volunteers, guests, family members of previous guests, board members, and administrators of SMHh programs. Results: Over the course of the study, five major themes were developed: (1) physical attributes of the home, (2) volunteer base, (3) attention to detail, (4) structure of accountability, and (5) practice of compassionate honesty. These themes reveal the beginning of an explanatory theory of why the SMHh concept can support the delivery of effective, high-quality EOL care. Conclusions: The result of this study substantiates SMHh as a viable alternative to traditional in-home or institution-based EOL care. As the SMHh movement develops, more research is needed to explore and understand how this emerging model of care can be implemented on a larger scale.

Keywords: Social Model Hospice; end-of-life care; hospice; qualitative descriptive.

MeSH terms

  • Caregivers
  • Empathy
  • Hospice Care*
  • Hospices*
  • Humans
  • Terminal Care*