Abstract
This article examines access barriers to hospice care for noncancer conditions. The difficulty in determining terminality for cancer and noncancer conditions is compared according to disease trajectory. Issues other than prognosis that affect delayed access to hospice care include: patients' knowledge of hospice, lack of a primary caregiver, lack of uniformity in hospice admission criteria, and physician-related barriers. Results of the Robert Wood Johnson Foundation SUPPORT study indicating wishes and directives of dying patients are examined. Nursing implications for increasing access to hospice care and the advantages of hospice care for patients and families are discussed. Reimbursement for hospice services are a covered medical benefit by many insurance carriers as reported by the National Hospice and Palliative Care Organization based on hospice patients who received care in 2001.