With the evolution of the hospice* movement, numerous questions have arisen regarding problems faced both by patients and by the staff who care for them. One question o f particular interest is whether the hospice setting in fact presents special stress to staff. Are the staff and volunteers who work in a hospice under more stress than those in an intensive care or acute care setting? Having recently completed a study of 400 caregivers working in a variety of settings around the world, I am now inclined to answer that those working in palliative care pro bably experience no more stress than caregivers working with the critically ill and dying in a variety of other settings. In fact, palliative care staff often have the advantages of a shared philosophy of care, a good staff-patient ratio, more rewards inherent in their roles, more built-in supports and more recognition than do a number of other caregivers. Nonetheless, problems do exist. There are stressors inherent in palliative care, and obvious manifestations of stress
reactions are in evidence. Staff in a number o f hospice care organizations now are highly motivated to make changes for both improved working conditions and decreased stress responses in caregivers.