ABSTRACT
The evolution of the hospice movement over the years was deliberate, focused, halting and uncertain, but sustained. The foundation which created the structure of such networking, led to the development of state hospice organizations and the National Hospice Organization. Hospice of North Iowa, and hundreds of other programs across the country, owes individual and collective successes in large part, to such organizations. Idealism, that characterized early hospice founders and leaders, is being tested by increased regulatory compliance and heightened governmental scrutiny. Others believe that hospice is beginning to look and act likes any other “specialty” in the field of health care. Many feel threatened by other organizations that are working to improve end-of-life care for all Americans. The change in the delivery of health care in the United States during the last few years has been ceaseless and chaotic.
