By the end of the 1960s, care of the dying had moved from home to hospital and was becoming increasingly impersonal and technologically managed. Intractable cancer pain was frequently grossly under treated, and patients often died in a hospital room at the end of the hall, behind a closed door, in pain, and alone. Despite medical and technological advances, needless suffering often accompanied death for both the dying and the bereaved. Health care reformers turned to hospice as an alternative to institutionalized care of the dying. Yet, almost 30 years after the first modern American hospice opened in Connecticut, society is still wrestling with questions of how to shape and finance end-of-life care for an increasing chronically ill, medically complex, and elderly frail population. The proposed research will be a case study of the Connecticut Hospice from 1965 to 1986, which will: 1) examine the cure/care dichotomy and its impact on care of the dying; 2) connect the influences of expanded nursing practice, technology, economics, and policy to the development of the Connecticut Hospice; and, 3) describe the translation of the hospice philosophy of care into a reimbursable model of care and explicate the role of nurses within that process. Such an analysis may illuminate the ability of the nursing profession to shape health care policy and provide insight into what is required to strengthen and sustain end-of-life care initiatives in the present, and into the future.
| Buck, Joy (2011) Policy and the Re-Formation of Hospice: Lessons from the Past for the Future of Palliative Care. J Hosp Palliat Nurs 13:S35-S43 |
| Buck, Joy (2009) 'I am willing to take the risk': politics, policy and the translation of the hospice ideal. J Clin Nurs 18:2700-9 |
| Buck, Joy (2007) Netting the hospice butterfly: politics, policy, and translation of an ideal. Home Healthc Nurse 25:566-71 |
