Abstract
Since the early 1970s, nurses have been involved with hospice care. Now, with the introduction of palliative care for the chronically ill and terminal patient, nurse practitioners are developing new roles within this specialty. Despite barriers to practice, new reimbursement guidelines and educational opportunities are advancing the role. Nurse practitioners are treating the frail elderly in a variety of settings, including skilled nursing facilities, outpatient geriatric clinics, and home care. This article reviews the clinical development of this role, reimbursement issues affecting care, and various professional alliances formed to promote further advancement.