Palliative medicine: facing the challenge of care beyond care.

All Native Americans (NA) age groups experience certain diseases and injuries for which there is no cure; however, the growing population of NA elders is carrying the greatest burden of chronic illness and pain-related symptoms. To palliate, literally, means, "to cloak." The term palliate medicine was used to describe an array of hospice services that were provided for the dying. The term now encompasses terminal care, comfort care, supportive care, pain management, end of life care, and hospice care. The field has attracted surgeons, internists, pediatricians, anesthesiologists, ethicists, geriatrics specialists, family practice physicians, oncologists, cardiologists, and public health professionals. The article provides an assessment and rating scale for pain. Recommendations for developing care include: 1) developing IHS Area policies; 2) collaboration with other sources; 3) training for health workers; and 4) increase awareness.