title: Barriers to accessing hospice services before a late terminal stage.
abstract: Although hospice care has been available in the United States for over 25 years, the trend of late terminal access persists.  Quality assessments and interventions that will continue through a year of bereavement are based on early interactions and the formation of caring and trusting bonds.  A qualitative research study was conducted to identify and describe barriers to timely access as perceived by those involved in hospice care: caregivers, hospice staff and volunteers, and referring physicians.  Major findings include persistent knowledge deficits including misconceptions and lack of awareness of components and skill associated with hospice care: reluctance to disclose, discuss, or acknowledge patient terminality, and access of hospice care being perceived as giving up on the patient.
authors.affiliation: Coatesville Veterans Administration Medical Center, Pennsylvania, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Johnson
authors.forename: S C
authors.initials: SC
authors.lastname: Slaninka
mesh_terms: D006297:Health Services Accessibility; D017051:Hospice Care; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D036301:Qualitative Research; D012106:Research; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*; D014481:United States