Death does not hover over the home of Robert and Libby Dawkins on a quiet road near Troy.

The Dawkins’ dog barks a wary welcome as hospice nurse Joy Maynor approaches with purposeful step and ready smile. Her visits link Robert, a former chaplain for the N.C. Department of Corrections, to a network of services that enable him to live at home with his illness.

“The hospital is great when you really need it,” says Robert, a veteran of 68 hospitalizations. “But the beauty of hospice is that they come and provide what you need at the time.”

Dawkins and the 3,952 patients served in Moore and Montgomery counties since 2000 know that FirstHealth Hospice and Palliative Care stresses living — comfortably and fully — in familiar surroundings with family, friends and volunteers aided by medical, pastoral and social work professionals despite a life-limiting illness.

In December, hospice broke ground for a 16,000-square-foot, 11-bed acute care facility on 30 acres overlooking a lake at a former RV park off U.S. 15/501 in Pinehurst. The $13.8 million facility includes a chapel, solace room, dining room and children’s play area, grief and counseling center and administration building. Hospice House will open next summer.

Medical advances have altered the face of hospice — a concept practiced since biblical times. Dame Cicely Saunders, a British physician, established St. Christopher’s, the first modern hospice, near London in 1967. Saunders brought the concept to America, where in 1974 the first hospice program opened in Connecticut.

A recent study reported that although 75 percent of Americans want to die at home, more than 90 percent die in the hospital, although Medicare and most insurance plans include a hospice benefit.

In 2007, North Carolina hospice associations operating 32 residences cared for 30,746 patients: 76 percent white and 16 percent African-American. The discrepancy, according to a spokesman for Carolinas Centers for Hospice and Palliative Care, results from tradition and culture.

The Hospice Foundation of America stresses that hospice is not a place, but a concept of care carried out, in the majority of cases, in a home or nursing home.

Locally, an independent organization was formed in 1980, with Dr. David Allen its driving force and a 99 percent volunteer staff, including Charlotte Patterson. Patterson became hospice director in 1999.

“It just hit me that this was something very important,” Patterson says. “(Hospice) is as pure as it gets — helping people make decisions. This is their journey, not ours, and they don’t get a second chance.”

Hospice speaks of this only chance, in several voices:

To read more if this story, the first of a two-part series on hospice, please see Sunday's print edition of The Pilot.