Complaints About Hospice Care in the United States, 2005–2015

2018 ◽  
Vol 21 (11) ◽  
pp. 1580-1587 ◽  
Author(s):  
David Stevenson ◽  
Nicholas Sinclair
Keyword(s):  
United States ◽  
Hospice Care ◽  
The United States

High–Tech, Aggressive Palliative Care: In the Service of Quality of Life

1993 ◽  
Vol 9 (1) ◽  
pp. 37-41 ◽  
Author(s):  
David M. Dush
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Health Care ◽  
Palliative Care ◽  
Hospice Care ◽  
High Technology ◽  
The United States ◽  
High Tech ◽  
Hospice Movement

The hospice movement grew in part as a reaction to the perception that modern medical care had become too technological at the expense of being impersonal and insensitive to human psychological and spiritual concerns. In the United States, the institutionalization of hospice care under Medicare and other reimbursement systems has further established hospice as an alternative to high-technology, high-cost care. The present paper examines the question: What if hospice care becomes itself high-technology, aggressive, costly health care in order to remain true to its goal of maximizing quality of life? Implications for the goals and philosophical underpinnings of palliative care are discussed.

Mo1504 HOSPICE CARE UTILIZATION AMONG ELDERLY PATIENTS FROM THE UNITED STATES (U.S.) WHO DIED WITH HEPATOCELLULAR CARCINOMA (HCC)

2020 ◽  
Vol 158 (6) ◽  
pp. S-1429
Author(s):  
Victor de Avila ◽  
James M. Paik ◽  
Leyla de Avila ◽  
Linda Henry ◽  
Denise Mohess ◽  
...  
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Elderly Patients ◽  
Hospice Care ◽  
The United States ◽  
Care Utilization

Demographics, Resource Utilization, and Outcomes of Elderly Patients With Chronic Liver Disease Receiving Hospice Care in the United States

2017 ◽  
Vol 112 (11) ◽  
pp. 1700-1708 ◽  
Author(s):  
Natsu Fukui ◽  
Pegah Golabi ◽  
Munkhzul Otgonsuren ◽  
Alita Mishra ◽  
Chapy Venkatesan ◽  
...  
Keyword(s):  
United States ◽  
Liver Disease ◽  
Elderly Patients ◽  
Chronic Liver Disease ◽  
Resource Utilization ◽  
Hospice Care ◽  
The United States ◽  
Chronic Liver

scholarly journals Rural-Urban Disparities in Place of Death in Hematologic Malignancies in the US from 2003 to 2019

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4137-4137
Author(s):  
Syed M. Qasim Hussaini ◽  
Arjun Gupta
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
Rural Areas ◽  
Hospice Care ◽  
Metropolitan Areas ◽  
Hematologic Malignancies ◽  
The United States ◽  
Medical Facility ◽  
Nursing Facility ◽  
The Us

Abstract Background: more than 60,000 people die annually from hematologic malignancies in the united states (us). Patients with hematologic malignancies more frequently receive aggressive care toward the end-of-life and are more likely to die in a hospital compared to those with a solid tumor. Appropriate care of such patients is very dependent on an existing healthcare infrastructure. There are notable challenges to rural healthcare in the united states which contains less than 1/5th of all hospices in the us. In this study, we sought to investigate rural-urban disparities in place of death the us in individuals that died from hematologic malignancies. Methods: we utilized the us centers for disease control and prevention wide-ranging online data for epidemiologic research database to analyze all deaths from hematologic malignancies in the us from 2003 to 2019. A population classification utilizing the 2013 us census was made using the national center for health statistics urban-rural classification scheme. These classifications included: large metropolitan area (1 million), small- or medium-sized metropolitan area (50 000-999 999), and rural area (<50 000). We estimated deaths in a medical facility, hospice, home, or nursing care facility. We stratified the results by age, sex, and race/ethnicity. The annual percentage change (apc) in deaths was estimated. All data was publicly available and de-identified. Findings: from 2003-2019, there were a total 1,088,589 deaths form hematologic malignancies in the united states, predominantly in large metropolitan areas (50.2%), followed by small or medium sized metropolitan areas (31.7%) and rural areas (18.2%). All regions noted decreases in medical facility and nursing facility related deaths, and increase in hospice and home deaths. While rural areas demonstrated the quickest uptake of hospice care (apc 61.5), they had the lowest overall presence of hospice care (8.3% of all rural deaths in 2019 vs. 14.9% for small or medium metropolitan vs. 12% for large metropolitan) and larger share of nursing facility related deaths (15.8% of all rural deaths in 2019 vs 12.3% for small or medium metropolitan vs 10.6% for large metropolitan). Discussion: we demonstrate end-of-life disparities in hematologic malignancies based on where an individual resides in the us with rural areas having notably lower share of deaths in hospice facilities. Older infrastructure, inadequate access to care, and financial barriers add to the medical complexity of care for all patients, and especially hematologic patients with high needs and complex treatment planning. These have been aggravated by rural hospital closures in the previous 18 months. The us senate is currently debating a bipartisan infrastructure that may add billions in building rural healthcare infrastructure to state budgets. Our findings are timely in helping inform congressional policy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Looming Threats to the Intimate Bond in Hospice Care? Economic and Organizational Pressures in the Case Study of a Hospice

2007 ◽  
Vol 54 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Elijah G. Ward ◽  
Audrey K. Gordon
Keyword(s):  
United States ◽  
Hospice Care ◽  
The United States ◽  
Ethnographic Case Study ◽  
Policy Changes ◽  
Client Care ◽  
Client Relationship ◽  
Midwestern City

Hospice organizations are assailed by stiff competition, ever-rising costs, limited funding, and policy changes. Do such pressures stifle the high quality of care these organizations strive to provide? As a case-in-point, we draw from the mid-1990s accounts of caregivers at a nonprofit hospice in a Midwestern city in the United States. We maintain that economic pressures drive organizational restructuring, which then weakens working conditions and, thereby, weakens the staff-client relationship. We discuss effects upon worker behaviors, the worker-client relationship, and client care. This ethnographic case study signals the need to closely examine the threats that current economic and organizational pressures in the United States may pose to the quality of hospice care.

Willingness to use hospice care among caregivers of Latino patients in the United States–Mexico border region

2016 ◽  
Vol 15 (3) ◽  
pp. 279-287 ◽  
Author(s):  
Eunjeong Ko ◽  
Jaehoon Lee ◽  
Carlos Ramirez ◽  
Stephanie Martinez ◽  
Denicka Lopez
Keyword(s):  
United States ◽  
Family Caregivers ◽  
Hospice Care ◽  
Underserved Populations ◽  
The United States ◽  
Border Region ◽  
Care Services ◽  
Mexico Border ◽  
Willingness To Use ◽  
Eol Care

ABSTRACTObjective:Hospice is an important method of promoting quality end-of-life (EoL) care, yet its utilization is relatively low in underserved populations. The unique characteristics of a border community—such as a lack of healthcare resources and cultural integration—impact EoL decision making. The aim of our study was to assess the willingness to use hospice care services and its predictors among family caregivers of Latino patients in the United States (U.S.)–Mexico border region of Southern California.Method:This study analyzes secondary data from a home health agency in the U.S.–Mexico border region. Quantitative data were collected via a face-to-face interview with 189 caregivers of patients enrolled in the agency. Bivariate tests and logistic regression were employed to address our study objectives.Results:The majority (83%) of family caregivers were willing to use hospice services for their loved ones. The factors impacting willingness to use hospice services included the primary language of the caregiver (OR = 6.30, CI95% = 1.68, 23.58); trust in doctors to make the right decisions (OR = 3.77, CI95% = 1.05, 13.57); and the belief that using hospice care means giving up on life (OR = 0.52, CI95% = 0.30; 0.88). Caregivers who trusted doctors to make the best decisions for their loved ones and English-speaking caregivers were more willing to utilize hospice services, while caregivers who held a strong belief that hospice care means giving up on life were less likely to consider using hospice care for their loved ones.Significance of results:The willingness of family caregivers to use hospice services for their loved ones is influenced by cultural perspectives about hospice care. As the importance of family involvement in EoL care planning has been highlighted, family caregivers' beliefs about hospice care services need to be addressed within their particular cultural context.

Hospice Approach to Palliative Care

2018 ◽  
Author(s):  
Sriram Yennurajalingam
Keyword(s):  
United States ◽  
Palliative Care ◽  
Social Work ◽  
Physical Therapy ◽  
Life Expectancy ◽  
End Of Life ◽  
Nursing Care ◽  
Hospice Care ◽  
The United States ◽  
Medicare Part

For the provision of palliative care in the hospice setting in the United States, Medicare covers any care that is reasonable and necessary to manage palliative and hospice care at end of life. To be eligible for this Medicare hospice benefit, a beneficiary must be entitled to Medicare Part A and be certified by a physician to have a life expectancy of 6 months or less if the illness runs its expected course. Medicare covers medications, nursing care, and medical services including care by a physician, physical therapy, social work. This chapter briefly reviews the various aspects of the Medicare hospice benefit.

scholarly journals Palliative Care and Hospice: A Paradigm for End-of-Life Care in Developing Nations

2017 ◽  
Vol 6 (2) ◽  
pp. 38-44 ◽  
Author(s):  
Peter A. Clark
Keyword(s):  
United States ◽  
Palliative Care ◽  
End Of Life Care ◽  
Hospice Care ◽  
The United States ◽  
Developing Nations ◽  
Comfort Care ◽  
Loved One ◽  
Legal Perspective ◽  
Fear Of Abandonment

Traditionally, medical care has had two mutually exclusive goals: either to cure disease and to prolong life or to provide comfort care. Given this dichotomy, the decision to focus on reducing suffering is made usually only after life-prolonging treatment has been ineffectual and death is imminent, usually by days or hours. As a result, one of the best kept secrets in a hospital today in the United States is palliative care and hospice care. We estimate that of the 2.4 million Americans that die each year, about 80% end their lives in hospitals attached to the latest advances in technology; 300,000 die at home under hospice care. The reasons why more people do not receive palliative or hospice care range from the patient’s fear of abandonment and the unknown, the family’s denial of the inevitability of death of their loved one, and physician’s denial of medicine’s limitations. Unless the options of palliative or hospice care are given to patients the fears that people have of dying--fear of dying alone and fear of dying in pain--will continue to make the dying process one that lacks dignity and respect. In this review article we have reviewed the state of palliative and hospice care in the United States through a historical, ethical and legal perspective. We have discussed its scope in the developing world and the potential challenges.Journal of Advances in Internal Medicine 2017;06(02):38-44.

The Leadership of Florence Wald: Listening to the Voices of the Early Hospice Founders and Colleagues

2009 ◽  
Vol 17 (4) ◽  
pp. 379-398 ◽  
Author(s):  
Cynthia C. Adams
Keyword(s):  
United States ◽  
Transformational Leadership ◽  
Hospice Care ◽  
Single Case ◽  
The United States ◽  
Shared Vision ◽  
Yale University ◽  
Leadership Model ◽  
Culture Of Inquiry ◽  
High Level

This qualitative study investigated the transformational leadership of Florence Wald who brought hospice care to the United States in the 1970s using the constructs of the transformational leadership model of Burns (1978). A single case study design was chosen to conduct an in-depth exploration of Florence Wald's transformational leadership and the perceptions of the group of founders organized to conceptualize, build, and open the first hospice in the United States. This research also examined documents from The Florence and Henry Wald Archives in the Yale University Library. The findings showed that Florence Wald based her leadership on strong values and a shared vision. To encourage a high level of participation, Wald demonstrated a caring component in her leadership and engaged in mentoring. A conclusion of this study is that Wald was successful in creating a culture of inquiry among the Founders which served to drive evidence-based decision making to improve the quality of palliative care in the United States.

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