This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members. Seconding Robichaux's argument is Backstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest of the ICU function as it should" (41).

Indeed, the image of a comfortable and quiet resting place for elderly patients are embodied in both hospice and nursing homes, which, compared against ICU-based EOL care, specifically target the elderly and provision of EOL care as its main goals. Both hospices and nursing homes do not provide EOL care as a secondary nor optional program infused within their own healthcare services, unlike in the ICU environment, wherein palliative care is but one of the programs only of the hospital, an additional healthcare service on top of the medical services it offers to people of all socio-demographic profile.

Hospices are considered as being able to meet the necessary EOL care needed by the patient. In addition to EOL care, patients are also able to receive "exceptional pain management while alleviating emotional burdens, providing spiritual support, and enhancing quality of life" (Elliot, 2006:85). Evidently, hospices provide a more individual-centered and multi-dimensional perspective to the concept of end of life care. It takes into consideration not only the...

yielded the finding that the nursing homes offer the best-practice EOL programs Imhof has categorized earlier, arguing that nursing homes is a fusion of both ICU EOL care and hospices. It is likened to ICU EOL care programs because of the existence of a medical staff that are professionally trained to care for the medical needs of the patient. It is likened to a hospice because of the holistic, individual-centered care it provides the patient. Thus, nursing homes are similar to Imhof's concept of hospital-based palliative programs, which meets both medical and EOL needs of the patient. However, it is important to note that unlike hospital-based care programs, nursing homes actually make it their main goal to provide efficient and quality end of life care services, unlike hospital-based programs that only provide EOL care as value-added feature of the hospital/medical facility.
Bibliography

Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.

Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.

Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.

Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.

Robichaux, C. (2006). "Practice of expert critical care nurses in situations of prognostic conflict at the end of life." American Journal of Critical Care, Vol. 15, Issue 5.