borderline personality disorder, countertransference, developmental theory, nurse-patient relationship, object relations theory, transference



  1. Hill, Ruth MA, BSN, PHN, RNBC, CHPN


Delivering hospice care in the home for patients can be overwhelmingly complicated when the patient also has a psychiatric diagnosis of borderline personality disorder (BPD). This article describes the development of BPD and identifies the atypical symptoms seen in elderly patients. Treatment differences between hospitals and hospice care are identified. An actual case study illustrates the use of a nurse-patient relationship or therapeutic alliance to achieve a peaceful death. The establishment of a positive transference relationship was identified as the most beneficial tool needed to effect a peaceful death in a patient with BPD.