Hospice in America: Comfort Care at End of Life

When I was asked to write this article on hospice nursing so that nurses in all areas of health care can understand hospice and promote its ideals, philosophy, and services, I felt a mix of apprehension and joy. I was apprehensive because for the past eight years, I've simply received patients. I'm not really on the front line of professionals that refer patients to hospice. Patients arrive on my caseload in various stages of acceptance of their situation. On the other hand, I felt grateful to be given the opportunity to share what I see as the power of hospice services: providing good physical symptom management, and relief of anxiety and fear about the spiritual aspects of dying and death, through the use of a knowledgeable team of experienced professionals. So, with that introduction, I will proceed to share my sense of awe and wonder and love of the hospice care we currently have in our country. Some of you may know that prior to 1983, hospice services were only for a few wealthy patients. These services were not reimbursed by private insurance companies, Medicare, or Medicaid. And in the years before the 1980's, dying patients were placed in hospitals, at the end of the hallway, to spend their last hours alone. Adequate symptom relief was not something many health professionals thought about. Dying patients were frequently ignored and allowed to pass away without the benefit of the wonderful medications we possess today.