| Course | NURS 6910 Introduction to Palliative Care: Principles of Hospice and Palliative Care |
|---|---|
| Week | Week 2 |
| Paper type | Concept comparison paper |
| Length | About 1,040 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | September 2026 |
Free sample paper for NURS 6910 Week 2
One Philosophy, Two Scopes: A Walker and Avant Comparison of Hospice and Palliative Care From Their Origins to Current Practice
Student Name
College of Nursing, Walden University
NURS 6910: Introduction to Palliative Care: Principles of Hospice and Palliative Care
Instructor Name
Month Day, Year
One Philosophy, Two Scopes: A Walker and Avant Comparison of Hospice and Palliative Care From Their Origins to Current Practice
Introduction
Hospice and palliative care are often used as synonyms by patients, families and even clinicians, and the confusion has consequences: families decline palliative care because they believe it means giving up treatment, and patients reach hospice in their last days because no one raised it sooner. This paper argues that the two concepts share one philosophy of care, attention to the whole person and family, relief of suffering and dignity in serious illness, but differ in scope, timing and eligibility. Their histories explain why. The paper traces each concept to its origin, compares them using Walker and Avant's concept analysis method (Walker & Avant, 2019) and then places both in current definitions and payment rules.
Origins
The modern hospice movement began with Cicely Saunders, who trained as a nurse, a social worker and then a physician, and who opened St Christopher's Hospice in London in 1967. Saunders (2001) described her founding aims as combining expert pain and symptom control with research and teaching, and she introduced the idea of total pain: suffering that is physical, emotional, social and spiritual at once. St Christopher's was a place, a freestanding house for the dying, and much of the early movement grew as a community alternative to hospital deaths.
The term palliative care came later and from a different setting. In the 1970s the Canadian surgeon Balfour Mount, after studying St Christopher's, established a service within a Montreal teaching hospital and chose the new name partly because the word hospice carried other meanings in French-speaking Quebec (Clark, 2007). His choice signaled a shift: the philosophy of hospice would be brought inside the acute hospital, where patients were still receiving active treatment. Clark (2007) traces how palliative care then moved from the margins of medicine toward its center, becoming a specialty with training, research and consultation services.
Concept Analysis
Walker and Avant's method asks the analyst to identify defining attributes, the features without which a case would not count as an instance; antecedents, the events that must occur first; and consequences, what follows when the concept is present (Walker & Avant, 2019). Applying each step to both concepts makes their overlap and their differences visible.
Hospice
Defining attributes. Interdisciplinary care whose aim is comfort and the best possible remaining life; care of patient and family as one unit; delivery mostly in the home or a residential setting; and a focus on the final phase of life, when treatment aimed at cure has ended or been declined. Antecedents. A serious illness judged to be terminal, a limited prognosis, and a decision by the patient or surrogate to shift the goal of care from cure to comfort. Consequences. Relief of symptoms at the end of life, support for caregivers, and bereavement care for the family after the death.
The antecedents carry the most weight. Hospice cannot begin until someone has judged the illness terminal and a decision has been made, which is why the concept is so closely tied to the moment of choosing it.
Palliative Care
Defining attributes. Interdisciplinary care focused on relief of physical, psychological, social and spiritual suffering; care of patient and family as one unit; availability in any setting; and provision alongside disease-directed treatment. Antecedents. A serious illness and the presence of needs, such as symptoms, distress or difficult decisions, regardless of prognosis. Consequences. Improved quality of life, better understanding of illness and options, care that matches the patient's values and, where needed, a smoother transition to hospice.
The antecedent here is need, not prognosis. A person newly diagnosed with advanced heart failure, receiving full treatment, meets the antecedents of palliative care but not of hospice.
Comparison
Table 1 sets the two concepts side by side.
Table 1
Hospice and Palliative Care Compared Using Walker and Avant's Categories
| Category | Hospice | Palliative care |
|---|---|---|
| Shared attributes | Whole person and family; interdisciplinary team; relief of suffering | Whole person and family; interdisciplinary team; relief of suffering |
| Distinct attributes | End of life; comfort as the goal; mostly home or residential | Any stage; alongside disease treatment; any setting |
| Antecedents | Terminal illness, limited prognosis, decision to forgo cure | Serious illness with needs, regardless of prognosis |
| Consequences | Comfort at the end of life; caregiver support; bereavement care | Better quality of life; aligned decisions; earlier transition when needed |
| Origin | Saunders, St Christopher's, a place for the dying | Mount, a service inside an acute hospital |
The table shows that palliative care is the broader concept. Every hospice patient receives palliative care, but most people who need palliative care are not hospice patients.
Contemporary Definitions and Payment
Current definitions follow the lines drawn by the two origins. A consensus definition developed by the International Association for Hospice and Palliative Care describes palliative care as the active holistic care of people of all ages with serious health-related suffering due to severe illness, including those near the end of life (Radbruch et al., 2020). The National Consensus Project guidelines in the United States describe palliative care as appropriate at any age and stage of serious illness and deliverable in any setting, and they treat hospice as one part of the palliative care continuum (Ferrell et al., 2018).
Payment rules then turned the conceptual difference into a practical one. The Medicare hospice benefit requires physician certification of terminal illness and an election by the patient, who sets aside coverage for curative treatment of the terminal condition (42 C.F.R. § 418.22). Palliative care outside hospice has no single benefit and is paid largely through ordinary visit billing. Hospice therefore became a defined benefit with clear eligibility, while palliative care remained defined by need and has been harder to fund and to find.
Conclusion
Hospice and palliative care share Saunders's philosophy of treating the whole person and the family. They differ because they grew in different places: one in a house for the dying, the other inside a hospital where treatment continued. For nurses, the practical lesson is to use the terms precisely. A family told that palliative care is "like hospice" may refuse help they need, while a family told that palliative care can begin now, beside treatment, has been given the concept as it is actually defined.
References
Clark, D. (2007). From margins to centre: A review of the history of palliative care in cancer. Lancet Oncology, 8(5), 430-438. https://doi.org/10.1016/S1470-2045(07)70138-9
Ferrell, B. R., Twaddle, M. L., Melnick, A., & Meier, D. E. (2018). National Consensus Project clinical practice guidelines for quality palliative care guidelines, 4th edition. Journal of Palliative Medicine, 21(12), 1684-1689. https://doi.org/10.1089/jpm.2018.0431
Medicare Hospice Care: Certification of terminal illness, 42 C.F.R. § 418.22 (2024).
Radbruch, L., De Lima, L., Knaul, F., Wenk, R., Ali, Z., Bhatnaghar, S., Blanchard, C., Bruera, E., Buitrago, R., Burla, C., Callaway, M., Munyoro, E. C., Centeno, C., Cleary, J., Connor, S., Davaasuren, O., Downing, J., Foley, K., Goh, C., ... Pastrana, T. (2020). Redefining palliative care: A new consensus-based definition. Journal of Pain and Symptom Management, 60(4), 754-764. https://doi.org/10.1016/j.jpainsymman.2020.04.027
Saunders, C. (2001). The evolution of palliative care. Journal of the Royal Society of Medicine, 94(9), 430-432. https://doi.org/10.1177/014107680109400904
Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed.). Pearson.
Reading the NURS 6910 Week 2 instructions
Week 2 prompts in this course typically ask you to compare hospice and palliative care as concepts, often using a concept analysis method, and sometimes to trace their development. A length of roughly four pages in APA style is common. Keep the history short and make every paragraph of it explain something about current practice. Choose a method, such as Walker and Avant's, and apply each of its steps to both concepts in the same order so differences stand out. A table that sets the categories side by side helps graders see the analysis quickly. Bring the comparison forward to current definitions and payment rules, and finish with what the distinction means for how nurses talk to patients and families.
How the NURS 6910 Week 2 example is put together
An introduction states the claim that the concepts share a philosophy but differ in scope. An origins section cites Saunders on total pain and the founding of St Christopher's and Clark on Mount's choice of a new term and palliative care's move into mainstream medicine. The method section explains the three categories from Walker and Avant. Hospice and palliative care each receive their attributes, antecedents and consequences, with a sentence noting that the antecedent carries the difference. Table 1 compares the concepts across five rows. A contemporary section cites Radbruch and colleagues' consensus definition, Ferrell and colleagues' guidelines and the hospice certification rule. A conclusion returns to the words families hear.
Reading the NURS 6910 Week 2 rubric
Concept papers are generally assessed on the method, the depth of the comparison, the use of sources and the relevance to practice. Method credit depends on applying each step of the chosen approach to both concepts rather than naming the steps and moving on. Comparison depth is judged by whether the paper finds the decisive difference rather than listing every small one. Historical sources earn credit when they explain current definitions. Current definitions should come from recognized bodies and be described accurately. Organization counts, and a comparison table is often where graders confirm the analysis. APA formatting, a clear thesis and a conclusion that links the analysis to nursing practice complete the usual criteria for this assignment.
Common NURS 6910 Week 2 mistakes, and how to avoid them
Comparison papers lose marks when the history runs for half the paper and the analysis is squeezed into a paragraph. Another frequent loss is applying the method to one concept carefully and to the other loosely. Some papers treat hospice and palliative care as synonyms in the conclusion, undoing their own comparison. Others quote payment rules with figures they have not checked. Keep the history brief and purposeful, apply every step to both concepts in parallel, name the difference that matters, place both in current definitions and say what it changes at the bedside. The desk can prepare a comparison using the method your course teaches. Cite primary historical sources where you can rather than secondary summaries.
Get a NURS 6910 Week 2 example written to your instructions
Tell the desk which concepts your Week 2 prompt pairs, since some sections compare palliative care with end-of-life care or with supportive care instead, and attach the rubric. The comparison comes back under your required headings in 24-48 hours, and a first request costs nothing. Historical sources are the ones the argument actually uses.
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NURS 6910 Week 2 questions, answered
Which concept analysis method does the paper use?
Walker and Avant's, chosen because its categories of defining attributes, antecedents and consequences suit a comparison between two related ideas. The example applies each category to hospice and then to palliative care before setting both in a table. If your course teaches Rodgers' evolutionary method or another approach, the same comparison can be organized around that framework instead.
How much of the paper is history?
About a quarter, and every paragraph of it points forward. Saunders is cited for the model of care she built, Mount for the term and the hospital setting it implied. A history section longer than the analysis usually signals a timeline, and your rubric is more likely to reward the argument the history supports than the dates themselves.
Does the comparison include the Medicare hospice benefit?
Yes, in general terms, as the clearest example of how hospice became a defined benefit with prognosis-based eligibility while palliative care stayed need-based. The paper describes certification of a limited prognosis and the choice to forgo curative treatment for the terminal diagnosis, without quoting regulatory figures. Any payer or state rule your prompt singles out is named from the sources you supply.
Where can I find a free NURS 6910 Week 2 sample paper?
The full comparison paper, origins, method, both analyses, the table and current definitions, is posted free on this page. A version using the method your course assigns can be requested.
What is the key difference the NURS 6910 Week 2 paper finds?
The antecedent: hospice begins with a terminal illness, a limited prognosis and a choice to forgo curative treatment, while palliative care begins with serious illness and need at any stage.