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London Underground Uk Map for Gill et al It is also important for carers’ needs to be supported in order that they are able to provide the patient with whatever support is needed during the final days and weeks of their life World Health Organization Expert Committee Hospices therefore provide this kind of environment, although hospice beds remain predominantly for cancer patients Seale However, do hospices make a difference? Carers of patients who had died in hospices reported that their’ patients were more aware that they were dying than did carers of those who had died in hospital, perhaps reflecting the ethos of openness encouraged in hospices ibid This openness regarding dying may enable greater preparation for death and bereavement among patients and spouse carers, which has, in turn, been associated with reduced levels of emotional distress e.g. Chochinov et al The positive differences attributed to hospice care are not consistently reported, however; for example, Seale and Kelly did not find a difference between hospice and hospital care in terms of the care and support provided to spouses. Thinking positively, this may reflect the changing nature of hospital care towards more holistic, psychosocial care, or thinking less positively, perhaps a growing medicalisation of hospices Crossley and Small With specialist nurses in hospitals, at least in terms of cancer services, and in the UK, we can perhaps infer that hospital care has become more holistic. Certainly, within England and Wales the National Institute for Clinical Excellence NICE guidance on Improving Supportive and Palliative Care for Adults with Cancer recommends that assessment and discussion of patients’ needs for physical, psychological, social, spiritual and financial support should be undertaken at key points such as at diagnosis; at commencement, during, and at the end of treatment; at relapse; and when death is approaching’ Key recommendation Whenever a person is facing death as a result of a long-standing illness, whether cancer or not, issues such as a good death’ and dying with dignity’ become salient and bring with them many ethical and moral debates. Research has consistently shown that older people do not fear death itself, as younger people do, but are more concerned about the process of dying and the fear of dying in pain or without dignity and self-control e.g. London Underground Uk Map 2016.