Hope is the anticipation of something better to come and an essential component of life. It is a complex notion that is fundamental to the promise of health care. Initially, hope is for cure or restoration of health but in terminal illness, when there is no longer the possibility of cure, hope rests in the knowledge and skill of the medical scientist to alter the course of disease and to prolong life. It is this expectation for renewed physical being that is the focus of every intervention. At the end of life, when science can do no more, hope endures, but the focus of hope changes. It becomes hope to find meaning in life, as it was lived, and in the time that remains. For most, however, the end of life unfolds in the scientific milieu of the hospital where the significance of redefining hope may not be considered, and many die without hope. The purpose of this article is to explore the meaning of hope, to highlight the necessity of redefining hope at the end of life, and to emphasize the importance of sanctuary in engendering hope through relationship. Hospice is proposed as a sanctuary for the final days, where the patient, family, and health professional discover a new meaning of hope through shared human experience.
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