Authors’ Preface

This fourth edition of Hospice & Palliative Care Handbook continues the mission of providing skillful, compassionate care to people with life-limiting illness while supporting their loved ones. Hospice is unique in a number of ways. Since the last edition, much has happened and changed in hospice from a regulatory, growth, and other micro and macro perspectives. This newest edition is dedicated to all the clinicians, managers, and families who make hospice a special way of caring for patients and their families. Hospice is still very unique in the Medicare space because the focus of care and support is not solely the patient, but the family, as identified by the patient.

For those of you new to hospice, this author can remember when there was no Medicare reimbursement for hospice services. Hospice was specifically started as a grassroots effort to embrace and honor patient wishes at end of life. This mission-driven care remains the structural basis in the best of hospice care delivery today. The foundational tenets of hospice must be embraced and complied with to be able to provide compassionate and skillful care at end of life for patients and their families—all while meeting the sometimes complex regulatory and other requirements. Hospice and hospice nursing is a practice and team-based care specialty, and as such, this must be the emphasis for care and services.

Dr. Betty Ferrell’s Foreword expertly explains the unique interface of a number of skill sets that are necessary for the best of hospice care. We thank Betty for the eloquence and message as well as her lifelong work in hospice and hospice nursing.

This newest edition is designed to help the entire team better understand and comply with the Medicare Hospice Benefit. This includes those managing and working in all hospice settings where the person “calls home.” We also acknowledge that hospice operations demand a unique commitment and attention to detail rarely found in other healthcare settings.

What is different about this new edition? We retained the same format and structure to better assist busy clinicians and other team members to access needed care planning and other information. Clinical care guidelines were expanded to include imminent death, pediatric, frailty and geriatric, and skin and wound hospice care. Frailty, age-friendly healthcare, and numerous other areas of evidence-based care were updated and added where needed. More robust and detailed areas related to symptoms and staging scales were also included. We are committed to improving health and care, and hope this newest, fourth edition further improves our actionable and collective efforts.