Rather than seeking a cure as with traditional western medical practices, hospice and palliative care puts an emphasis on the quality of life by concentrating on symptom, pain, and stress reduction to alleviate patient suffering through the use of a multidisciplinary approach. This medical approach to patient care is deemed appropriate for patients with acute and chronic diseases, as well as for patients at the end of their life. While the palliative care treatment methodology seeks to relieve symptoms without providing a curative effect on the underlying disease or cause, hospice care addresses only those who are considered terminal, that is, with a life expectancy of less than six months. With respect to advanced disease progression, concerns pertaining to physical, emotional, spiritual, and social issues are addressed with regard to the patient and their loved ones.
This paper will explore the evolution of hospice care in the United States as well as the benefits and limitations of this delivery system. Particularly, the under utilization of this alternative philosophy of care as well as contributing cause for this will be identified. The role of the advanced practice nurse in the palliative care setting will be addressed. In addition, the advance practice nurse’s professional duty with regard to the function as change agent is considered. Hospice and palliative care practices are underutilized and misunderstood by many providers in the context of an era where health care is a profit making industry; simultaneously, aggressive practices intended to extend the life span of mankind does not necessarily meet the needs or wishes of individuals. To meet these needs, alternatives to traditional western medicine must continue to evolve and to be elucidated with regard to the U.S. population and providers.