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I have been given the privilege of writing the Preface for this wonder-
ful work, The Hospice Team: Who We Are and How We Care.
Hospice is a carve-out of the Medicare benefit. In 1983, monies
were set aside to pay for the care of Medicare recipients who had a
terminal diagnosis and who chose comfort care in their home or other
place of residence (skilled nursing facility, assisted living). It seemed
intuitive that people at the end of life would choose quality over quan-
tity and, if given the support and care necessary, to stay home. In the
1980s, most hospices were voluntary organizations. Once hospice
became a Medicare benefit, many of these organizations developed
into more structured programs. With money, they could hire chaplains,
social workers, nurses, and other professionals who became what is
now known as the interdisciplinary team.
The interdisciplinary team is the cornerstone of care at the end
of life and comprises multiple professionals who bring their expertise
to bear in formulating a plan of care for patients and their families.
In hospice, we care not just for individual patients, but also for an
ever-expanding group of concentric circles made up of family, friends,
and others whose lives are affected by the individual’s illness and
approaching death.
The Hospice Team is written from the standpoint of different
members of the interdisciplinary team: physicians, nurses, certified
nurse assistants, social workers, music therapists, volunteers, bereave-
ment counselors, and chaplains. Each of us offers a unique perspective
on the work we do and why we do it. Some of us wrote about what
drives us to do what we do and how we chose to work in hospice; some
of us describe in detail what our job entails. But we all bared our souls
and tried to show what drives us to care for terminally ill people.
xiii
xiv The Hospice Team