Barriers to accessing hospice services before a late terminal stage

Although hospice care has been available in the United States for over 25 y ears, the trend of late terminal access persists. Quality assessments and i nterventions that mill continue through a year of bereavement are based on early interactions and the formation of caring and trusting bonds. A qualit ative research study was conducted to identify and describe barriers to tim ely access as perceived by those involved in hospice care: caregivers, hosp ice staff and volunteers, and referring physicians. Major findings include persistent knowledge deficits including misconceptions and lack of awarenes s of components and skill associated with hospice cars: reluctance to discl ose, discuss, or acknowledge patient terminality, and access of hospice can being perceived as giving up on the patient.