cation are, as a matter of course, different from this criterion. However, home hospice care is not necessarily the best program for every cancer pa As family members of the patient are in tient at the terminal stage. It was concluded that olved with home hospice care in Japan(1), they home hospice care is an exclusive right given only develop relationships with the dying patient in- to patients and their families who wished to dependently. Therefore, the object of death edu- spend their remaining days together at home cation is not merely the dying patient but also the caretakers, the patient's family. Death educa- Change in Death Education According to the tion for the family is no less important than it is Condition of the Patient for volunteers who are involved as team mem- In home hospice care, the curriculum of death pers in hospice care(5). Participation of the fam- education should change with the condition of ily in providing care is important in terms of the patient. It is necessary to educate the patient manpower and for bereavement care after the and family to reach the goals set for each stage patient's death(6). The death education in home of the dying process hospice reported here was performed through At the initial stage we must understand the trial and error and we examined the way in wish of the patie lent correct ctly and, at the same which the deceased and the bereaved spent their time, an objective assessment of the ability of the remaining time together. Our death education family to provide care is important. At this nethods involved many problems and should stage, the significance of hospice care(7, 8)and be further improved through daily practices. especially of its application at home should be Establishment of a universal system of death ained in detail to the patient and family. The education will use information collected by doc- goal of education at the stable stage should be for the patient and family to accept death as a Goals of Death Education natural phenomenon and to understand ciousness of the remaining days of life so that the Deeken(3)reported 15 goals concerning death patient can live in peace. In the final stage,the education. However, some such as the sixth doctors and nurses should explain that death is goal, which was related to suicide and the 12th inevitable. However, the family often told the goal which was related to the art of death were patient the significance of life and how wonderful not included in death education for home hos- it was. Thus, during death education in home pice care. hospice care, the medical attendants were not Among goals considered important for home merely specialists and teachers but also students hospice care were When the patient's condition is stable and the dying process family is self-possessed (3), young family mem preparation for death(2nd) bers or grandchildren can learn about life and grief education(3r) death. For example, Patient 14's grandson said, elimination of fear of death(4 h) n response to a question during a TV interview: understanding the preciousness of the re As my grandfather was at home I could see him etting weaker day by day. Home hospice care is hard work all right, but it is an experience that one Some other educational goals were unsuitable should have once in life for home hospice care or too complex for gen eral death education These included: When a doctor knows that death is approach removal of the taboo concerned death (5th) g, he/she must inform the family so that other matters relating to the right to know for a relatives can be told and arrangements such as the funeral service, death costume, and portrait terminal cancer patient (7th) moral matters on death( 8th) can be made. When death is imminent, educa- tion regarding the process of death, possible autopsy (9th) preparation for funeral service(10th) changes, and how to care for the patient should death philosophy(13 th) be provided We explained that the medical staff religious matters(14 could be reached at any time, so the family the possibility of an afterlife(15) ould feel comfortable about providing the final one if poss For successful home hospice care, both the pa An important point of education at this stage tient and family must choose and support this was to let them know that the patient would be service. Death education in home hospice care is free from agony, but their consciousness would provided for the patient and family who fulfill be retained until the last moment. Accordingly, Reproduced with permission of the copyright owner. Further reproduction prohibited without permissionReproduced with permission of the copyright owner. Further reproduction prohibited without permission