Early in the 20th century, there were few choices to be made about one's final hours and even rarer discussions about that final journey. Within the past two decades, hospice programs changed the discussion about death and where people choose to die, according to local experts.

With the advent of palliative care in 21st century, Butler County residents with terminal illnesses have more control over the quality of the end of their lives as well as their deaths.

“It's OK for them to die at home, and it's OK to be on a hospice program, and it's OK to make choices about not wanting certain treatments, so that has gotten better,” said Suzanne Grove, director of hospice and palliative care of VNA, Western Pennsylvania Lutheran Senior Life.

While VNA served Allegheny, Armstrong, Butler, Lawrence, Mercer and northwest Westmoreland counties since 1981, the organization no longer provides in-patient hospice following a national trend of facility closings across the United States.

And although the places where hospice is administered may have changed, the need for the program — which provides care and support for people with a life expectancy of six months or less, and palliative care focusing on helping terminally ill people and their families maintain their quality of life — is growing.

This is an excerpt from the first article in a series about pallative care. Subscribe online or in print to read the full article in Sunday's Butler Eagle.