The Hospice journal
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Oncology and hospice literature have addressed the problem of psychiatric complications, secondary to the stressors of diagnosis and treatment. This literature focuses particularly on depression and anxiety, which not only compound patients' suffering but also may interfere with optimal care. ⋯ In order to contribute to collegial dialogue that addresses this minority population in hospice services, a case study is presented in this article of the process of care for a hospice patient with a preexisting psychiatric condition. Interventions are suggested, using a theoretical matrix of hospice philosophy and principles of care for manipulative patients.
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The Hospice journal · Jan 1996
Hospice inpatient care: an overview of NHO's 1995 inpatient survey results.
Hospice inpatient care is currently provided through a variety of arrangements, including freestanding facilities, dedicated units, and contracted beds, but lack of standard definitions of the various types of arrangements has led to confusion about the number and type of facilities actually in operation. This study identified a total of 97 freestanding facilities and dedicated hospice units with a total of 1,165 beds. Fifty-six percent were freestanding facilities; the balance were units located within other facilities, primarily hospitals. ⋯ Length of stay for the acute level of care averaged 9.7 days with a median of 6.8 days for the 36 reporting facilities. Length of stay for residential care averaged 33.2 days with a median of 30 days for the 22 reporting facilities. Bed size, total inpatient days of care, average daily census, occupancy rate, and charges are also reported by facility type.
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The Hospice journal · Jan 1996
Comparative StudyDifferences in patient demographics and expenditures among Medicare hospice providers.
This study compares differences in demographics and Medicare expenditures for beneficiaries in 4 different types of hospice programs: hospital based, skilled nursing facility (SNF) based, home health agency based, and freestanding across the years 1987-1990. Enrollment and expenditures in hospital based hospices is increasing faster than for other types of hospices; at the same time, both hospital and SNF based programs are attracting greater proportions of non-white and female beneficiaries but fewer beneficiaries with non-cancer diagnoses. These results indicate that expansion of the hospice benefit has increased institutionalized use of hospice and that this institutionalized form of hospice may benefit demographic groups that previously underutilized the hospice benefit.
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A state-wide survey was conducted of highly effective hospice volunteers who were questioned about their motivations for becoming a volunteer, training experience and needs, and reasons for continuing in the volunteer role. Needs identified included having a volunteer support group, on-going training opportunities, and opportunities for getting to know other volunteers better. Excellent training, belief in the hospice mission, the relationship with staff, feeling valued, and personal fulfillment were strengths and motivations to continue as a hospice volunteer. Findings from the study will be helpful to hospice staff who recruit, train, and support volunteers.
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This study examines demographic, medical, and psychosocial variables in relation to preference regarding place of death on the part of 171 patients and their families treated at the Home Care Unit of the Oncology Department at Linn Clinic in Haifa, Israel, in 1992-93. Women who had breast cancer, and patients aged 50-59 with few mobility problems, preferred to die at home. ⋯ Patients with prostate and brain cancer and patients aged 60 and older spent the most time (1-3 weeks) in a nursing home and tended to die there. Patients who were in a hospice tended to speak less about death than other patients.