A pilot study of palliative medicine fellows' hospice home visits.

Title

A pilot study of palliative medicine fellows' hospice home visits.

Creator

Shoemaker LK; Aktas A; Walsh D; Hullihen B; Khan MIA; Russell KM; Davis Mellar P; Lagman R; LeGrand SB

Publisher

The American Journal Of Hospice & Palliative Care

Date

2012

Subject

Female; Humans; Male; Prospective Studies; Aged; Middle Aged; Pilot Projects; Patient Education as Topic; 80 and over; DNAR; Palliative Care/mt [Methods]; Palliative Care/ma [Manpower]; home care services; hospice care; Physicians; Medication Reconciliation

Description

This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify the indications for physician HVs and the problems addressed during the HV. Data was collected on 58 consecutive patients using a standardized form completed before and after the home visit. More than half of the persons were women. Most were Caucasian. Median age was 75 years; 57% had cancer; 77% were do-not-resuscitate. 76% HV occurred in the home. The median visit duration was 60 minutes; median travel distance and time 25 miles and 42 minutes, respectively. A hospice nurse case manager was present in 95%. The most common issues addressed during HVs were: health education, symptom management, and psychosocial support. Medication review was prominent. Physicians identified previously unreported issues. Symptom control was usually pain, although 27 symptoms were identified. Medications were important; all home visits included drug review and two thirds drug change. Physicians had unique responsibilities and identified important issues in the HV. Physicians provided both education and symptom management. Physician HVs are an important intervention. HVs were important in continuity of care, however, time-consuming, and incurred considerable travel, and professional time and costs.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Citation

Shoemaker LK; Aktas A; Walsh D; Hullihen B; Khan MIA; Russell KM; Davis Mellar P; Lagman R; LeGrand SB, “A pilot study of palliative medicine fellows' hospice home visits.,” Pediatric Palliative Care Library, accessed October 13, 2024, https://pedpalascnetlibrary.omeka.net/items/show/11441.