Issues with the provision of care to the terminally ill patient in nursing homes.

The need for new special care programs to care for nursing home patients who are dying and know it is discussed. Four different types of dying patients are identified according to their special needs. The hospice concept is described and conclusions are made about its application to the nursing home. In particular, it is concluded that: (1) nursing home administration need to form joint efforts with hospitals and home health services in deciding how to meet needs of dying patients; (2) a team concept is a good way to provide hospice care; and (3) current staff of nursing homes need to be educated in managing the patient who is dying and knows it.