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The Evolution of the Hospice Movement in America

William E. Finn ; Center for Hospice and Palliative Care, Buffalo

Puni tekst: hrvatski PDF 2.029 Kb

str. 271-279

preuzimanja: 1.093



The hospice movement in America has been shaped by several key factors, which in unison have created a unique and effective hospice model, yet a model that is also limited in creativity and scope to meet the changing future needs of America's dying. A home-care based hospice model has permitted rapid growth and disbursement of hospice services throughout America. The desire to de-institutionalize care of the dying and to provide holistic care and support shaped the culture of hospice care. Likewise, the incorporation of federal reimbursement for care created the initial catalyst for program development. These same regulations, however, have stunted hospice growth by creating programmatic disincentives, including a limitation of care for persons with prognosis of six months of life or less. The short length of stay in hospice has resulted in part from our culture's emphasis on full use of technology regardless of associated cost. The American dichotomy between care and cure underscores the need for end-of-life care that supports the transition from primarily curative to primarily palliative care. What should be recognized is that the two must co-exist to effectively support a terminally ill patient as he or she progresses toward the end of life.

Ključne riječi

death and dying; hospice; palliative care; community-based; federal reimbursement; PACE model

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