Providing hospice care in rural Texas

Hospice organizations in rural areas face many logistical and financial challenges. The authors review their experiences in offering hospice care to a widely dispersed population of patients. Crown of Texas Hospice, headquartered in Amarillo, Texas, provides hospice care throughout most of the vast and sparsely populated Texas panhandle. In the United States, patients typically are not referred to hospice care until the very end of the terminal phase of their disease process. Late referrals limit the opportunities for optimal symptom management and also limit the ability of a hospice organization to meet the psychosocial and spiritual needs of patients and their families. Recommendations to improve the timeliness of hospice referral are suggested.