What’s your passion?

I am passionate about hospice. Yet how did that come to be? As I reflect on my more than 25 years in hospice care, I recall attending my first Texas Hospice Conference in Lubbock, Texas just after becoming employed by Hospice in the Pines, Incorporated.  This was the most incredible educational endeavor I had ever experienced, and the individual breakout sessions provided such vision for end-of-life care. This, in essence began, to cultivate the passion I hold so valuable today. Of course, leaders in this impeccable industry expect to grow as they gain knowledge, and I certainly have been granted many opportunities to advance my profession.

While hospice has been a staple in the United States since the time of Dame Cicely Saunders’ work at Yale University in the mid 1960’s, it continues to bridge gaps among healthcare providers today. Many years ago I had the privilege to meet Dame Saunders at a National Hospice and Palliative Care Conference in Washington, D.C. and I witnessed her distinct passion for service. She unveiled the true values of each hospice discipline, and how holistic care improves the death experience. Although Dame Saunders developed breast cancer late in life, she continued to work and advocate for hospice care.  She died in 2005, at age 87, under the care of St. Christopher’s Hospice. It was the extent to which Dame Saunders had invested in education throughout her journey to improve humanity that captivated my attention. I wanted to work diligently and unselfishly to touch the lives of those I served through hospice.  Today, I continue to be committed to a lifetime mission of promoting goodwill and serving every patient as though they were my family. With high integrity and sincere compassion, I know the legacy of Dame Saunders breathes within me.

Hospice, as well as palliative care, continues to face barriers and challenges among clinicians, patients, and families. Hospice programs around the country have been unable to directly avoid late referrals and the common misconceptions associated with hospice. Each day team associates are facilitating difficult conversations, managing grief among families, and addressing regulatory standards – all while providing treatment to individuals with limited life expectancy. As the hospice industry continues to evolve there is more conversation focused on doing more with less without affecting quality. Many may wonder how one’s passion can remain firm and not waver under the current conditions. While I have observed much conflict and opposition over the past 25 years, there are four key elements that require urgent resolutions:

  • rapid and impending signs of the rate changes
  • late referrals
  • managing expectations
  • palliative care versus hospice care

We must prioritize having open and truthful conversations about hospice and palliative care, while providing more timely referrals which will ultimately ensure better quality of life. Hospice has been often synonymous with palliative care, but now we can demonstrate the broader definition with the growing number of palliative care programs over the past decade.

Change is inevitable, of course. As we continue to observe changes, as well as challenges in hospice care, we must recognize the valuable platform TNMHO provides for those of us in this special business enterprise.  As a member of TNMHO I have been able to ensure my team members are vested in the best educational endeavors, and provided quality resources to support our program. For example, we have one of the best “We Honor Veterans” programs, and we built it through a partnership with NHPCO and TNMHO. As a board member for TNMHO, I am energized by the robust engagement of our exceptional group of leaders – people who are dedicated to the duties of hospice care. I am honored to be a part and observe the profound impact made annually.  The movement of hospice is about to reach treacherous and controversial grounds as the conversation of managed care becomes an unprecedented reality. For TNMHO members it is of great worth to have such an extraordinary group of hospice advocates to lead the discussion.

Determining whether a patient is physically ready for hospice is a simple process, but getting everyone on board to access services can be difficult.  We can all relate to the many families who describe their hospice experience as wonderful. I often open cards and letters that acknowledge our staff as true guardian angels, but this is usually after a very emotional decision to consent to hospice care. Until it happens to you, one can never imagine how incredible hospice can be and how the entire interdisciplinary team embraces the patient as well as their family. Hospice is always going to face barriers, but through education, ethical hospice programs, and eradicating fraudulent abuse, this is winning half the battle, as well as cultivating a passion that will last a lifetime.

I recognize the advantages of hospice, and I remain unselfishly obligated to share this precious gift with my loved ones.  I can personally acknowledge the difference hospice made for my family and I will be forever grateful for the beautiful team members who cared for us.  You see it is not just about providing the care but it is also about accepting the care. I am just one of the many passionate leaders around the state who embody this labor of love for hospice.

The Texas & New Mexico Hospice Organization is your best hospice education resource, and membership demonstrates your pledge to education, ethics, and advocacy for the work we do.  I lead a hospice organization, but it’s more than work for me – it’s my passion. Make it your passion – because the care we give will one day be the care we need.



Demetress Harrell – MA, LBSW, ACHE

Demetress is Chief Executive Officer for Hospice in the Pines where she has been employed since 1993.  She is a member of the board of directors for TNMHO, and also serves on the NHPCO – NCHPP CEO Executive Director Steering Committee.


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