HPNA Vanguard Award

The Hospice and Palliative Nurses Association Vanguard Award, previously known as the Leading the Way Award, recognizes a nursing leader who has advanced the field of hospice and palliative nursing and is someone who has made a major contribution that has a national impact on hospice and palliative care. The recipient is recognized for outstanding leadership skills and commitment to the vision of HPNA and to our Pillars of Excellence: Advocacy, Education, Research, and Leadership. Nominations will be screened by the HPNA Awards Selection Committee. The HPNA Board of Directors will review the recommendations for approval. 

Recipients will receive:

  • Award with engraving 
  • Travel to an HPNA Annual event (if applicable)
  • Three nights hotel stay (if applicable)
  • Full registration to HPNA Annual event

The recipient will exhibit:

  • A significant contribution to the overall mission of HPNA.
  • A major contribution that has a national impact on hospice and palliative nursing.
  • Longevity through 15 years of experience in hospice and palliative care (preferred).
  • HPNA membership history of at least five continuous years. 
  • Current HPNA membership. 
  • Current HPNA, HPNF, and HPCC Board Members are not eligible. 

Vanguard Award Recipients
2024 – Margaret “Meg” Campbell, PhD, RN, FPCN 

Dr. Campbell is a professor emeritus at Wayne State University College of Nursing in Detroit, Michigan. In her career, she has been a pioneer in nurse practitioner-led inpatient palliative care and has conducted clinical research to assess and manage dyspnea among patients with advanced disease at the end of life with a particular focus on critical care. She is credited with developing the Respiratory Distress Observation Scale (RDOS), the only known valid and reliable tool for measuring respiratory distress in patients unable to self-report. Dr. Campbell served on the HPNA Board of Directors from 2007-2010, including as president in 2009. She has also volunteered on multiple HPNA committees and contributed to HPNA publications on dyspnea assessment and management and ventilator withdrawal.

2023 – Pat Berry, PhD, APRN, CNP, FPCN

Dr. Berry is an Adjunct Professor of Education and Practice at the University of Utah College of Nursing. Her scholarly works have focused on pain and symptom management, palliative and end-of-life care, especially for the institutionalized elderly. She has published numerous articles in peer-reviewed journals and co-authored the book entitled: End of Life care: Clinical Practice Guidelines for Advance Practice Nurses. This book was selected as an American Journal of Nursing Book of the Year in 2003.

Dr. Berry also coordinated the project that produced the Joint Commission on the Accreditation of Healthcare Organizations’ pain assessment and management standards. As a member of the National Board for Certification of Hospice and Palliative Nurses (NBCHPN®), Dr. Berry was involved in the development of the hospice and palliative advanced practice nursing certification examination and renewal process. She served as a member and as Chair of NBCHPN®‘s Advanced Practice Registered Nurse Exam Development Committee. Currently, there are over 2,476 nurses with this credential Advanced Certified Hospice and Palliative Nurse (ACHPN®). Dr. Berry was inducted as a Fellow of the American Academy of Nursing in 2009 and as a Fellow in Palliative Care Nursing by the Hospice and Palliative Nurses Association in 2012. 

2022 -Jeannette Kates, PhD, CRNP, AGPCNP-BC

Dr. Kates is an associate professor and director of the adult-gerontology primary care nurse practitioner program at Thomas Jefferson University in Philadelphia, PA, and a palliative care adult nurse practitioner. In addition to her more than 25 years of clinical experience in palliative care, oncology, and geriatrics, she is engaged in research to improve access to palliative care, address engagement in treatment-related decision-making, and mitigate disparities in serious illness. She is a recipient of the Hillman Serious Illness and End-of-Life Emergent Innovation grant and the Independence Blue Cross Clinical Care Innovation grant. Inspired by her experience in palliative care, she is passionate about interprofessional education and works with the Jefferson Center for Interprofessional Practice and Education at Thomas Jefferson University to develop and facilitate programming related to palliative care and serious illness. Dr. Kates has been involved in a variety of HPNA committees and initiatives, including the advance care planning task force, subject matter expert for APRN POLARIS, and the 2021-2025 Research Agenda.

2021 – Heather Coats, PhD, MS, ANP-BC

Dr. Coats is a palliative care adult nurse practitioner who serves as the director of research for HPNA and an assistant professor at the University of Colorado College of Nursing, Anschutz Campus. She has more than 20 years of clinical experience in palliative care, oncology, and hospice care. Prior to joining the faculty, Dr. Coats completed a two-year postdoctoral NIH/NHLBI T32 fellowship at the University of Washington/Cambria Palliative care Center of Excellence, and she was a NINR predoctoral fellow during her doctoral education at the University of Arizona College of Nursing, where she received the Outstanding Dissertation Award. Her research interests focus on improving psychological, social, and spiritual well-being through the development of narrative interventions with patients and families living with serious illness. 

2020 – Sandra Lee Schafer, MN, RN, AOCN

Sandra is awarded this honor posthumously. She worked as the Director of Credentialing for HPCC for 14 years. She was instrumental in credentialing tens of thousands of nurses and always displayed great passion in promoting the value of professional certification. Before her time at HPCC, she was an Oncology Clinical Nurse Specialist for 25 years at UPMC Shadyside in Pittsburgh. Her work focused on palliative care/oncology as well as pain and symptom management. 

Sandra was an active member and past president of the Oncology Nursing Society, founding president for the Greater Pittsburgh Chapter of ONS, and co-founder of Camp Raising Spirits, which continues to provide a retreat for individuals with cancer and their guests. 

Sandra held several leadership positions on the local and national levels of the American Cancer Society, Pennsylvania State Cancer Pain Initiative, and the Pennsylvania Society of Oncology and Hematology. She was also an active member of the American Board of Nursing Specialties, the Institute for Credentialing Excellence, the American Society of Pain Management Nurses, and Sigma Theta Tau. 

2019 – Betty Ferrell, PhD, MA, RN, CHPN, FAAN, FPCN

Dr. Ferrell is the director of nursing research at the City of Hope Medical Center and the editor-in-chief of the Journal of Hospice and Palliative Nursing. Her commitment to nursing research is exemplary. She has received continuous funding from the National Institutes of Health for almost three decades and has published more than 460 papers and a dozen books in the field. Dr. Ferrell is the primary investigator of the End of Life Nursing Education Consortium (ELNEC) project, which celebrates its twentieth anniversary in 2019. ELNEC has trained more than 726,000 people in all 50 states and in 99 countries.

Dr. Ferrell has represented HPNA on various projects, most recently as the co-chair of the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines. She is a Fellow in Palliative Care Nursing, has won both the Distinguished Career Achievement Award and the Distinguished Nursing Researcher Award, and was recognized by the American Academy of Hospice and Palliative Medicine in 2013 as one of 30 visionaries in the field of hospice and palliative medicine.   

2018 – Beverly Paukstis, RN, CHPN, FPCN

Ms. Paukstis has been practicing in hospice for more than 30 years, and most recently served as the Executive Director for Community Hospices of D.C. and Maryland, where she was also the administrator for intake and part of the Clinical Manager/Facilities Team.  A frequent presenter on a variety of hospice and advocacy topics at both the regional and national level, she was named a Fellow in Palliative Care Nursing in 2015. Ms. Paukstis served two terms on the board of directors for HPNA and on the board of the Hospice and Palliative Credentialing Center.

Ms. Paukstis has initiated and supported policy and advocacy efforts that ultimately led to the initiation of HPCC’s certification exam for advanced practice registered nurses. She is past chair of the HPNA Education Committee, and is actively involved in public policy issues. She has served as a role model and champion to many nurses and professionals in our specialty. Throughout her career, Ms. Paukstis has displayed commitment, compassion, and an unwavering dedication to enhance care for individuals and their families. 

2017 – Barbara Head, PhD, RN, CHPN, FPCN

Dr. Head was an associate professor at the University of Louisville School of Medicine, Division of General Internal Medicine, Palliative Care and Medical Education, and an affiliated faculty member at the university’s Kent School of Social Work. She is a registered nurse with advanced degrees (MSSW, PhD) in social work. Dr. Head has been involved in hospice and palliative care initiatives for over 30 years serving as a hospice board member, volunteer, home care nurse, educator, quality improvement coordinator, educator, and researcher.

She has been certified in hospice and palliative nursing for over 15 years, and has served as both a member and as president of the board of directors for the Hospice and Palliative Credentialing Center and the Hospice and Palliative Nurses Association, where she was honored in 2011 as a Fellow in Palliative Care Nursing (FPCN). Dr. Head was a board member and treasurer of the Social Work Hospice and Palliative Network, and has taught for the End of Life Nursing Education Consortium (ELNEC) both nationally and in India and Malaysia.

Dr. Head’s research focused on interprofessional education in palliative care, lung cancer survivorship programs, socioeconomic factors influencing cancer care, and telehealth interventions in cancer. She was interested educationally in the development and analysis of reflective capacity in students and the use of contemporary film to stimulate critical thinking related to death and grief theories and issues.

2016 – June Lunney, PhD, RN

As the extramural program director at the National Institute of Nursing Research at the National Institutes of Health (NIH) from 1991 until 1999, Dr. June Lunney participated in the creation of federal support for research on end-of-life issues. She organized the first NIH workshop on end-of-life care in 1997 and founded the Trans-NIH Palliative Care Group. She later worked at the Center for End-of-Life Care at RAND, where she was a major contributor to a study on the costs and use of care. She was the lead author on the 2003 Institute of Medicine’s report Describing Death in America: What We Need To Know. Dr. Lunney served as the associate dean for research at West Virginia University from 2003 to 2008 and as HPNA’s first director of research from 2010 until 2015.

Dr. Lunney has advanced palliative care through her role on multiple national committees and task forces. She chaired the 2004 NIH State of the Science End-of-Life Care Conference planning committee, served on the technical advisory group for the Assistant Secretary of Health’s project to improve end-of-life care in Medicare, and co-chaired the National Quality Forum’s steering committee on palliative and end-of-life care.

Dr. Lunney received funding from NIH to study trajectories of dying. In 2003 she published a seminal paper in the Journal of the American Medical Association, which provided empirical support for different patterns of functional decline at the end-of-life. Her current research links decision-making, physical and cognitive function, symptom burden, and healthcare utilization in advanced old age. 

2015 – Brenda Clarkson, RN

Brenda Clarkson is Executive Director of the Virginia Association for Hospice & Palliative Care. In the course of her stellar career, she has made numerous professional contributions, which include: serving as a founding board member of the Hospice Nurses Association (now the Hospice and Palliative Nurses Association) and as the second president of the association; founding board member and the first president of the National Board for Certification of Hospice Nurses (now the Hospice and Palliative Credentialing Center).

Ms. Clarkson has served in numerous clinical and administrative positions, which include; hospice nurse, clinical manager and administrator. She founded the first hospital-based inpatient hospice unit in Virginia. In addition, she has developed, marketed, and implemented a comprehensive range of consultative services for hospice and home health agencies. Ms. Clarkson has developed and implemented numerous innovative programs and services that have improved the delivery of hospice and palliative care services to patients and their families. Some of these initiatives include: a virtual Quality Improvement department with hospice clients, an orientation program for hospice nurses and a system-wide project to integrate palliative care into a Catholic Health System.

Ms. Clarkson has presented at state and national conferences on topics ranging from compassion fatigue, improving nurse retention through mind/body technologies, communication skills, documentation for compliance, developmental stages of hospice team members, and regulatory compliance and clinical excellence. She recently co-authored a book, The Heart of Hospice: Core Competencies for Reclaiming the Mystery, with the intent of preventing the heart of hospice from being lost in the midst of challenges currently facing hospice programs.

Leading the Way Award Recipients
2014 – Nessa Coyle, ACHPN, PhD, FAAN

The HPNA Leading the Way award recognized nursing leaders who had pioneered an innovative and novel approach to palliative nursing, and demonstrated a deep and abiding commitment to furthering the philosophy, mission, and quality of palliative nursing. For her continuous research, her focus on furthering patient goals of care, and her extensive scholarly and professional nursing leadership, we honor our 2014 recipient, Nessa Coyle, ACHPN, PhD, FAAN.

Dr. Coyle’s development of one of the first Nurse Fellowship programs in the US designed for advanced practice nurses in pain and palliative care, and her considerable research with its focus on palliative nursing, end-of-life care, and clinical bioethics, mark her commitment to changing lives and improving outcomes. Former Director of the Supportive Care Program of the Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center (MSKCC), she retired in 2012 after 40 years of service. The Nurse Fellowship program that she initiated at MSKCC is now over two decades old.

Dr. Coyle co-authored, with Dr. Betty Farrell, the Oxford Textbook of Palliative Nursing, a core resource text for the palliative care field. She is a co-leader of the HPNA Bioethics special interest group, which launched in 2013. Dr. Coyle is on the editorial boards of several interdisciplinary palliative care journals, including both the Journal of Pain and Symptom Management and the Journal of Hospice and Palliative Nursing. A member of the International End-of-Life Nursing Education Consortium (ELNEC) faculty, Dr. Coyle lectures both nationally and internationally. She is on the Board of the Visiting Nurse Service of New York Hospice program and is active in a variety of other community programs associated with palliative care and end-of-life care. 

2013 – Jane Marie Kirschling, DNS, RN, FAAN

Dr. Kirschling serves as Dean and Professor, School of Nursing and University Director of Interprofessional Education at the University of Maryland in Baltimore. Dr. Kirschling is past president of HPNA and served on numerous committees specific to governance, education, and research during her tenure. Additionally, she was board representative to the Coalition for Hospice and Palliative Care and the Alliance for Excellence in Hospice and Palliative Nursing. A major re-structuring of board and committee processes, designed to increase participation of HPNA members in the work of the association, occurred during her board tenure as Co-Chairperson of the Transitions Task Force. As a result of this re-design, HPNA now realizes over 300 member volunteers annually who contribute thousands of hours to our association’s work product.

She served as an HPNA representative to the American Academy of Hospice and Palliative Medicine’s Annual Assembly Steering Committee (2000-2002). Dr. Kirschling previously served on the Hospice and Palliative Nurses Foundation Board of Directors and is also a former HPNF president. Her contributions to both HPNF and HPNA continue in her current role as a member of the Palliative Nursing Leadership Institute Planning Committee. 

2012 – Virginia Tilden, DNSc, RN, FAAN

Virginia Tilden is Dean Emerita, University of Nebraska Medical Center College of Nursing; Professor Emerita, Oregon Health & Science University; and currently serves as Chairperson on the American Academy of Nursing Task Force on Policy and End-of-Life Care. She was previously Director of the Program of Research on End of Life Care, Center for Ethics in Health Care, at Oregon Health & Science University (1990-2003).

Dr. Tilden has received continuous National Institutes of Health funding over the past 20 years for research on improving care at the end of life, focused especially in three areas: advance care planning; the impact on families of making decisions to withhold or withdraw life-sustaining treatment; and palliative end-of-life care in nursing homes. She has over 50 data-based publications on care at the end of life in high impact journals, including The New England Journal of Medicine, Journal of the American Geriatric Society and Journal of Palliative Medicine.

Dr. Tilden has received numerous honors and awards, including the Lifetime Achievement Award from the Midwest Nursing Research Society, the Pathfinder Distinguished Researcher Award from the Friends of the National Institute of Nursing Research, a Distinguished Faculty Award for Research from the Oregon Health & Science University; the Helen Nahm Distinguished Research Award from the University of California San Francisco; and the Youmans Spaulding Distinguished Professorship Award from the Oregon Health & Science University. She was also inducted as a Fellow of the American Academy of Nursing in 1988. 

2011 – Madalon O’Rawe Amenta, RN, MN, PhD

Madalon O’Rawe Amenta, RN, MN, PhD, is being acknowledged with this year’s award for her remarkable work as the Executive Director of the Hospice Nurses Association (HPNA) from 1993 through 1997. Dr. Amenta dedicated her career to community nursing and was inspired to join the hospice movement in the 1970s after having read Elisabeth Kübler Ross’ On Death and Dying. After serving on the hospice planning committee at Pittsburgh Hospital, she eventually became Director of Education and Research at Forbes Hospice. This, in turn, led to founding the Pennsylvania Hospice Network and serving two terms as its first president. Her illustrious career has also included being a hospice career-related researcher, author, editor, academic educator, and mentor. She has received numerous honors in recognition of her caring work.

Some of her many professional honors include the Heart of Hospice Award from the National Hospice Organization in 1998; National Hospice Organization President’s Award of Excellence for a publication in the Hospice Staff Training and Development Category for the manual Quality Assurance for Hospice Patient Care, 1988; American Journal of Nursing Book of the Year in the Gerontologic Nursing Category for Nursing Care of the Terminally Ill, 1986; and the Yale University School of Nursing Distinguished Alumna Award, 1982. 

2010 – Ida M. Martinson, BS, MS, PhD, FAAN

Dr. Martinson’s career began as a diploma graduate of St. Luke’s Hospital School of Nursing in Duluth, MN. She earned her BS and Master’s degrees in Nursing Administration from the University of Minnesota. In, 1972 she earned a PhD in Physiology from the University of Illinois, where she continued to serve as a lecturer in the department of physiology and became a professor in the school of nursing in 1977. Dr. Martinson was then recruited by the University of California-San Francisco (UCSF) in 1982, where she worked in a well established research program focusing on the care of children with terminal illnesses.

During her years at UCSF, she took a leave of absence to serve as chair of nursing and head of the department of health sciences at the Hong Kong Polytechnic University in Hong Kong. Having spent many years as a consultant to nursing schools in various Asian countries, Dr. Martinson has a longstanding commitment to Asian cultures and has extensively studied the impact of childhood cancer on the child and family and care giving practices of Chinese, Taiwanese, and Korean families.

Dr. Martinson has received national and international recognition for her work, which includes more than 100 published articles, 65 book chapters, and six books. She is recognized for her willingness to share her data with young investigators as a mentor. She has held numerous visiting professorships, served on editorial boards, and received the Humanitarian Award from Pediatric Nursing.

2009 – Denice Sheehan, PhD, RN, and Deborah Witt Sherman, PhD, APRN, ANP-BC, ACHPN, FAAN (co-recipients)

Dr. Sheehan and Dr. Sherman are being acknowledged with this year’s award for their remarkable efforts to further enhance the quality of nursing care through leading the way in graduate hospice and palliative care education. 

Dr. Sheehan is an Assistant Professor at the Kent State University College of Nursing in Kent, Ohio, where she teaches both graduate and undergraduate level courses. Before her professorship with Kent State, Dr. Sheehan served as Coordinator with the Palliative Care Program at the Ursuline College Breen School of Nursing in Pepper Pike, Ohio. In the area of research, Dr. Sheehan has extensive experience investigating the interaction patterns between parents with advanced cancer in hospice and their adolescent children. She has given professional presentations on the topics of communication near the end of life, nursing research, palliative care, palliative nursing in academia, and decision making at the end of life. Dr. Sheehan’s work has been published in numerous journals and texts, including the American Journal of Hospice and Palliative Medicine, Journal of Hospice and Palliative Nursing, American Journal of Nursing, Journal of Pain and Symptom Management, Textbook of Palliative Nursing, and Hospice and Palliative Care: Concepts and Practice. Since 1999, Dr. Sheehan also has served on the Advisory Board and Faculty of the End of Life Nursing Education Consortium (ELNEC).

Dr. Sherman is an Associate Professor with tenure within the division of nursing at NYU, where she has also served as Acting Director of the Doctoral Program in Nursing and coordinator of the Advanced Practice Palliative Care Master’s and Post-Master’s Certificate Programs. She also provides palliative care and education across seven skilled nursing and assisted living facilities as Palliative Care Nurse Practitioner and Educator at the Regional Hospice of Western Connecticut located in Danbury, CT. As an accomplished researcher, her interests include breast cancer education and counseling, palliative and oncology care, quality of life, symptom management, and AIDS/HIV. She has presented widely and published extensively on a variety of subjects relating to end-of-life and palliative care, including patient fatigue, culturally competent care, and suffering of the caregiver. Her work has also appeared in such diverse journals as American Journal of Hospice & Palliative Medicine and American Journal of Nursing. In 2008, she received the Outstanding Contribution to the College of Palliative Care from the Academy of Hospice and Palliative Medicine. Dr. Sherman also serves on the editorial board of the Journal of Pain and Symptom Management. 

2008 – Jeanne Quint Benoliel, DNSc, RN, FAAN

Dr. Jeanne Quint Benoliel graduated from St. Luke’s Hospital School of Nursing in San Francisco, served in the United States Army Nurse Corp., received her B.S. from Oregon State University, her Master’s from the University of California, Los Angeles and her DNSc from the University of California, San Francisco. Her commitment to the care of the dying began with her work with Barney Glaser and Anselm Strauss. She continued her work studying patterns of communication and behaviors of the terminally ill. As a result of her studies, Dr. Benoliel was able to document that the care for the dying destroyed quality of life in their final moments, was misdirected and expensive secondary to the flurry of invasive activities noted at that time.

She has taught courses, written extensively and conducted many workshops on end of life care. She was the first to bring in the family in terms of the unit of care. She was well ahead of her time. Dr. Benoliel was the first nurse president of the International Work Group on Death, Dying and Bereavement. She is recognized as one of the founders in the field of hospice and palliative care. Through her work and teaching, she has transformed nursing care for the dying as well as shaped the field of palliative and hospice care. HPNA is quite honored to recognize this wonderful nursing leader as the 2008 HPNA Leading the Way award winner. 

2007 – Pamela S. Hinds, RN, MSN, PhD, FAAN

Dr. Pamela Hinds is the Director, Division of Nursing Research at St. Jude Children’s Research Hospital in Memphis, TN, a full member of St. Jude Children’s Research Hospital as well as an Adjunct Professor at the University of Tennessee, College of Nursing and the University of Pennsylvania School of Nursing. With more than 25 years experience in research, Dr. Hinds has been the principle investigator of numerous research grants is widely published with more than 150 manuscripts, as well as textbooks, guidebooks, monographs and book chapters and has been the recipient of numerous awards.

Dr. Hinds’ primary interest in research includes decision making, quality of life, fatigue and end of life. She is actively involved in many ways with the Children’s Oncology Group as well as the Oncology Nursing Society where she chaired the ONS Multi-site Research Project Team and was a member of the National Quality Forum Review Committee, Framework and Preferred Practices for Palliative and Hospice Care Quality. Dr. Hinds presents extensively and currently serves on the editorial board for the Journal of Pediatric Oncology Nursing and as a reviewer for many other peer reviewed journals. Dr. Hinds credits her husband, as well as sons Ben and Adam, for all these successes. 

2006 – HPNA Past-Presidents

The HPNA Leading the Way Award recognizes a nursing leader who has “led the way” in hospice and palliative nursing. The 2006 recipients of this award are the 11 HPNA Past-Presidents, honored for their contributions as nursing leaders in end-of-life nursing. 

2005 – Madalon Amenta, RN, MN, PhD

The HPNA Board of Directors has chosen Madalon O’Rawe Amenta RN, MN, PhD to be honored in 2005 for a multitude of contributions as a nursing leader in end-of-life care. Dr. Amenta, the nurse, was inspired to join the hospice movement in the 1970s after having read Elisabeth Kübler Ross’ On Death and Dying. After serving on the hospice planning committee at Pittsburgh Hospital she eventually became Director of Education and Research at Forbes Hospice. This, in turn, led to founding the Pennsylvania Hospice Network and serving two terms as its first president. Her illustrious career has also included being a hospice career-related researcher, author, editor, academic educator, and mentor. She has received numerous honors in recognition of her caring work. Madalon Amenta is the recipient of the 2005 HPNA’s “Leading the Way” Award. 

2004 – Florence Wald, PhD, BA, MN, MS

The first recipient of the HPNA Leading the Way Award was indeed born a nursing leader. Experiences from the early days of her life forged the values, ethics, and passion to become, as HPNA affectionately calls her, the “mother of hospice and palliative nursing”. The HPNA Board of Directors proudly announces that this individual is Dr. Florence Wald, the nursing pioneer for establishing hospice in America. Through her leadership and commitment, hospice care was initiated in the United States in 1974. Her influence has continued over the last 2½ decades as healthcare leaders in America have joined together to improve end-of-life care in America.

Dr. Wald, a nursing graduate of Mt. Holyoke College, earned a Masters in Nursing and a Masters in Science from Yale University. Her illustrious career has included serving as a researcher, academic educator, dean, author, and speaker. She is currently a Clinical Professor at the Yale University School of Nursing serving as a role model, mentor, and researcher with many accomplished colleagues. Dr. Wald has been a champion in the care of the dying patient. “From the nurse’s point of view, hospice care is the epitome of good nursing” says Dr. Wald. “It enables the patient to get through the end of life on their own terms. It is a holistic approach, looking at the patient as an individual, a human being. The spiritual role nurses play in the end-of-life process is essential to both patients and families,” says Dr. Wald.