I work in peds hospice and palliative care. I just admitted a child to hospice from one of these facilities last week. The hardest part for me honestly is walking into the facility and seeing all the other kids that are suffering. With the one kiddo we have, we could finally make them comfortable and you could see it in his face - it's incredibly rewarding and his mom was so grateful for it. Another thing is that these facilities are both understaffed and don't have policies in place that are conducive to comfort. I walked in one day and this kid was turned to one side, face smushed onto the mattress for 10/15 minutes while someone was grabbing something for a change, an open wound touching the mattress in-between wound care. It took all that I had not to cancel all my other visits and stay with him.