The Hospice journal
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Functioning as a hospital-based hospice program of a large medical center, bereavement services are not limited to hospice families in one location. Bereavement services are offered to those who died within the medical center and to the residents of the three county area the hospice serves. This paper identifies ways to offer bereavement follow-up to hospice and non-hospice families. ⋯ We will discuss survey results, meeting and support group data used to generate supporting information to allow our services to grow. Learning objectives for this article consist of readers being able to identify ways to develop and expand bereavement services; incorporating various types of death in a support group setting; and ways to better serve non-hospice families in need of bereavement follow-up. Topics include a description of Bereavement Services; Pre-Death Bereavement Intervention; Open and Closed Support groups; Routine Bereavement Follow-up of Hospice families; Quarterly Nursing Home Staff Support groups; Widow/Widower Brunch Social; opportunities to educate the community about Death/Dying; and data collection for Bereavement Needs.
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The Hospice journal · Jan 1995
Clinical Trial Controlled Clinical TrialThe McCanse Readiness for Death Instrument (MRDI): a reliable and valid measure for hospice care.
The purpose of this study was to establish whether or not readiness for death, as an indicator of healthy dying, is a measurable concept. Review of relevant literature revealed consensus regarding the universality of a human need for healthy dying. A theory of healthy dying was derived from the Rogerian paradigm. ⋯ Debilitating illness and actual mortality in the study sample precluded and/or confounded estimates of test-retest reliability. Convergent validity of the MRDI was indicated by significant correlations between patients' scores and primary caregivers' estimates (r = .35, p < .05) and between patients' scores and primary hospice nurses' estimates (r = .53, p < .01). Discriminant validity of the MRDI was demonstrated by a significant mean difference between the group of terminally-ill patients and the group of non-terminal, cardiac-impaired patients (t = 1.76, p < .01).
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The Hospice journal · Jan 1995
Feasible criteria for enrolling end-stage dementia patients in home hospice care.
Hospice care is considered appropriate for end-stage dementia patients (Luchins & Hanrahan, 1993), yet less than 1 percent of hospice patients have a primary diagnosis of dementia (Hanrahan & Luchins, 1995). This pilot study tested the feasibility of providing palliative care for dementia patients. A common eligibility requirement for admission to hospice is that the patient is likely to die within six to seven months. ⋯ The enrollment criteria proved successful in that the median survival time was five months, with an average of seven months. Eight of the 11 patients died during the study. Hospice care was well accepted by family caregivers and appeared to meet the patient's needs.
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The Hospice journal · Jan 1995
Barriers to pain management in hospice: a study of family caregivers.
Cancer-related pain not only affects the patient but the family/caregiver as well. The purpose of this study was to examine concerns about reporting pain and using analgesics in a sample of primary caregivers of cancer patients receiving care from a hospice program. The Barriers Questionnaire (BQ), an instrument designed to measure eight common barriers to adequate management of cancer pain, was administered to 37 persons identified as primary caregivers. ⋯ Finally, caregivers of patients who reported pain was not a problem on program admission had greater concerns about tolerance and were more likely to believe that "good" patients do not complain. The caregiver, often, with time and the declining abilities of the patient, becomes the first line decision maker regarding the patient's care and treatment. Understanding caregiver perspectives is important for continued success with managing pain in hospice and, arguably, all settings.
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The Hospice journal · Jan 1994
Patient and physician characteristics affecting the choice of home based hospice, acute care inpatient hospice facility, or hospitals as last site of care for patients with cancer of the lung.
In this exploratory study we found that in 1986, in Clark County, Nevada, home based hospice services were utilized at a very limited level for lung cancer patients. A nontraditional acute care hospice facility, however, was heavily utilized; but only slightly less so than community hospitals. ⋯ The findings and hypotheses lend support to further studies of the most cost effective last site of care for terminal lung cancer. The need for an ongoing examination of the impact of public policy on the definition of hospice and careful consideration of nontraditional models is indicated.