Patients may spend weeks, days or only hours here while doctors and a staff of nurses and aides control their pain or agitation, social workers counsel and chaplains guide. Since it opened in 2004, more than 1,400 people have died here…

Family members frequently return, often on anniversaries, to walk or sit in the yard.

"The families are just so thankful. They feel so grateful. The pain is being handled. They can kind of, not enjoy the process of death, but the stress is taken off," nurse Joy Favaedi said, as two of Butkus' grandchildren played in the living room. "It's a sad place, but such a positive place."

…Advocates for hospice — which focuses on comfort in the last six months of life, normally at home — view the political debate as a reflection of cultural reticence to accept death or recognize a downside to persistent life-extending measures. Places like Bruns House fill a need for acute hospice care in a homelike setting…