A Dozen Changes Over a Dozen Years

Posted by Western PA Hospital News on Nov 15, 2011 in Hospice | 0 comments

By Judy Lentz, RN, MSN, NHA 
CEO, Hospice and Palliative Nurses Association 

As I near retirement, I can’t help reminisce about the changes I have experienced in my twelve years as CEO of the Hospice and Palliative Nurses Association (HPNA).  Although hospice began in the United States nearly 35 years ago, the past 12 years have been explosive in expanding the philosophy, increasing utilization and moving the care upstream earlier in the disease trajectory thereby branding the service with a new name – palliative care.

Hospice in the United States has been altered by legislative action and regulatory guidelines to fit a restricted time limited care delivery which requires certification by physicians to assure the disease will cause death in 6 months or less if the disease follows its normal course.  These restrictions have created limited acceptance by hopeful Americans thereby generating greater acceptance for a less regulated, less restrictive and more palatable care delivery model called palliative care.

Initiated in 1995, palliative care been more available to those experiencing serious illnesses who want options, to be able to make their own choices, to be in control, to receive holistic person centered care provided by an expert interdisciplinary team and to seek all options available to improve quality of life as the patient/family define it.  Matching treatments to the person’s preferred goals of care is the focus of those involved in palliative care with no timelines, no limitations, no denial of options.    As the serious illness progresses, the team of care providers support and information to assist in decision making and recommend hospice when appropriate.  This allows the patient to experience each day to the fullest while preparing for a peaceful dignified death with bereavement support for the family thereafter.  This trajectory can be days, weeks, months, or years in length.

When I was hired by the HPNA twelve years ago, palliative care was a vision.  Now a dozen years later, palliative care is a reality.  Changes that I have experienced include:

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