This paper focuses upon the emergence of a new phenomenon in the late nineteenth century: institutional provision for the 'respectable poor' medically certified as 'dying'. For the first time this group was identified as having special medical, nursing and spiritual needs, which could only be provided by trained staff through an institutional medium. Through a comparative study of three institutions founded in London - St Joseph's Hospice, the Hostel of God and St Luke's House - this paper aims, firstly, to consider why it is important to look at late nineteenth century homes for the dying; secondly, to understand why they were set up during this period; and thirdly, to explore their foundation and development up to 1914. It argues that the homes were essentially a response to perceived deficiencies in medical, domiciliary and spiritual care for the dying 'respectable' poor: as religious and philanthropic institutions, the homes were profoundly influenced by wider developments in these areas. Within the homes, spiritual care was viewed as the most important part of their work. Although they professed to be non-sectarian, the distinct denominational basis of each home (Catholic, Anglo-Catholic and Methodist) had a profound impact on perceptions of death and dying. Particularly significant are the accounts of patients, written by various members of the homes, which reconstruct the patients' deathbed experiences in certain ways.