Hospice care in America

Abstract

Hospice care, an appropriate way of caring for many terminally ill patients, now is reimbursed by Medicare and other insurance systems. However, access to hospice care is limited by unavailability, ignorance, Medicare regulations, and internally imposed restrictions. Reasons for the barriers to hospice care and other appropriate terminal care are discussed, together with potential actions that might improve care for dying patients.

KIE: The medical director of a hospice reviews the state of hospice care in the United States. Rhymes outlines the history and philosophy of the modern hospice movement and summarizes the findings of recent studies comparing the efficacy and costs of hospice care with those of conventional care of the dying. She identifies and discusses barriers to hospice care, which currently is available only to a small proportion of terminally ill patients in the United States. Rhymes concludes with suggestions of changes that could renew and expand the role of hospices and lead to more humane care for the dying.