ps even fall. More than half of the nation’s hospices including the vast majority of rural hospices, had their per diem payments reduced, effective October 1, 1997, under a new hospice wage index (Stair, 1998). About 53 percent of hospices were affected negatively during 1998-2000 (National Hospice Organization, 2000). In order to develop a palliative care strategy and maintain the different services provided by hospice programs in the United States, a palliative care program include the following strategies: * Hospice programs need to clearly define their guidelines for care of patients. * Guidelines and procedures for a palliative care model should be developed by hospice programs, that in collaboration with those agencies that care for the terminally ill can implement the plan of care needed by terminally ill patients. * The program needs to set realistic objectives for measuring outcomes such as patient comfort and level of pain at the end of life. * All patients in hospice care need to be reevaluated on monthly basis to determine the appropriateness of their care setting. * Communication and documentation procedures need to be standardizing to reduce paperwork and streamline reporting. * Treatment protocols need to be implemented to ensure that pain and other symptoms are treated consistently and logically. Why hospice care is so important? The greatest gift that any individual can give to a terminally ill patient is a dignified death surrounded by love, comfort and care. Since the beginning of time such death were common. The person dying stayed at home and was cared for by family members, but with the advances in technology care for the dying has changed. During the 1960’s hospitals became the place terminally ill people went to die (National Hospice Organization, 1999). This concept changed family involvement in the care of their own. In 1980’s the tide starting to change, and terminally ill patients were allow...
