ABSTRACT
This chapter identifies the obstacles, limitations, and challenges of palliative care as well as its achievements. The palliative care movement recognizes that many of us eventually find ourselves in situations at the edge of hope and endurance. There is a continuing effort to develop improved care techniques. Hospice must also keep itself alive and well, even when confronted by daunting challenges. Hospice programs usually provide care at the patient's home and in medical care facilities, as needed. There is a third alternative: respite care. There were barriers, however, to hospice care for persons with AIDS, when this condition became recognized as a major public health hazard in the 1980s. The hospice team has particular expertise in controlling what otherwise would be unremitting pain. Palliative care takes place within a complex and shifting mix of circumstances: cultural, political, and economic, as well as medical.
