The Hospice journal
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This large, long-term study of families served by hospice found that nearly 95 percent said hospice had been helpful. Still, about 30 percent of family members said there was something they wish hospice had done differently. Those who had some complaint were more likely than those who had no complaints to be women, to report the patient had needed a great deal of care, to have a history of depression and greater levels of distress before and after the patient's death, and to be dissatisfied with the support they received from family members and friends.
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The Hospice journal · Jan 2000
Intermittent subcutaneous injections for symptom control in hospice care: a retrospective investigation.
An alternative route to oral medications used by some hospice programs is intermittent injections of medications using an indwelling subcutaneous butterfly needle. The nurse places the infusion sets and instructs caregivers on medication administration. Although this method has become more common in hospice care, it has not received much attention in part because of a lack of data to support its efficacy. ⋯ Morphine was used most frequently for pain, and Ativan was used most frequently for anxiety. Side effects from the medications and problems with this route of administration were rarely reported, thereby supporting the practicality of this method in hospice care. These results form the foundation for a prospective study that is documenting staff, patient, and caregiver variables that impact on the effectiveness and manageability of this method of symptom management in hospice care.
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The Hospice journal · Jan 2000
Physician attitudes toward palliative care at a community teaching hospital.
The goals of the study were to explore physicians' attitudes and opinions about palliative care and its implementation. Four focus groups composed of attending physicians were conducted by a professional facilitator at a community teaching hospital. ⋯ Problems they perceived were a lack of education for physicians, residents, other health care professionals, and the general public; a lack of hospital support systems to implement palliative care appropriately, and a lack of knowledge and support regarding legal considerations. They believed that a palliative care unit was a reasonable tool to overcome many obstacles to good end-of-life care.
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The Hospice journal · Jan 2000
The role of primary caregiver denial in inpatient placement during home hospice care.
This study conducted with a sample of 68 home hospice patients revealed that primary caregivers in denial of the patient's terminality were more likely to place hospice patients in inpatient treatment. Moreover, patients placed in inpatient settings were more likely to die there, rather than at home as planned. These findings suggest an impact of primary caregiver denial upon patient self-determination, and indicate the importance of addressing denial in counseling with primary caregivers of terminally ill patients.
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The Hospice journal · Jan 2000
Association between administrative and ownership characteristics of hospices and their proportion of inpatient deaths.
Hospice patients are more likely to die at home than patients involved in conventional medical care, but the proportion of home deaths varies between programs. A study of the effect of hospice administrative characteristics on inpatient death rates is presented. ⋯ This difference was explained by the presence of dedicated inpatient hospice units: Programs with such units demonstrated higher inpatient death rates than those without (42% versus 11%; P < .00001). Though not necessarily causal, these associations should be of interest to patients, physicians, families, and policy-makers.