There has been little research conducted with terminally ill patients in the UK to date. This case study describes statements made by a palliative care patient during a face-to-face interview while he was being treated in a hospice. His comments illustrate his unhappiness within the hospice environment to an extent that could compromise his holistic management in this setting. We would suggest that the important aspects of patient care include not just the major palliation issues of symptom control and good communications, but also attention to the rituals of daily living of individuals pertaining to the environment. The atmosphere of the hospice, as experienced by patients through their interactions with staff members within the care setting, is seen to be a significant factor for good holistic care. Hospices may need to be more aware of the impact that every member of staff, both clinical and non-clinical, can make at each patient contact. Becoming more alert to the likes and dislikes of each patient as regards the substance of these contacts may allow hospices to avoid institutionalized care practices and instead to individualize the care they offer to a greater number of their patients.