At the crossroads: making the transition to hospice

Title

At the crossroads: making the transition to hospice

Creator

Schulman-Green D; McCorkle R; Curry L; Cherlin E; Johnson-Hurzeler R; Bradley E

Publisher

Palliative & Supportive Care

Date

2004

Subject

Female; Humans; Male; Adult; Parent-Child Relations; Interpersonal Relations; Questionnaires; Aged; Middle Aged; Family Relations; Non-U.S. Gov't; Research Support; U.S. Gov't; Caregivers/psychology; decision making; Connecticut; Palliative Care/psychology; Narration; Hospice Care/psychology; Neoplasms/nursing; Non-P.H.S.

Description

OBJECTIVE: Previous studies reveal that many terminally ill patients never receive hospice care. Among those who do receive hospice, many enroll very close to the time of death. Nationally, between 1992 and 1998, the median length of stay at hospice declined 27%, from 26 to 19 days. In our prior study of 206 patients diagnosed with terminal cancer and using hospice, we found that one-third enrolled with hospice within 1 week prior to death. Late hospice enrollment can have deleterious effects on patients and their family members. The aim of the present study was to characterize common experiences of patients and primary family caregivers as they transition to hospice, focusing on caregiver perceptions of factors that might contribute to delays in hospice enrollment. METHODS: We conducted in-depth interviews with a purposive sample of 12 caregivers selected from a population of primary family caregivers of patients with terminal cancer who enrolled with hospice in Connecticut between September 2000 and September 2001. Respondents represented different ages, genders, and kinship relationships with patients. Respondents were asked about the patient's care trajectory, how they first learned about hospice, and their experiences as they transitioned to hospice. NUD*IST software was used for qualitative data coding and analysis. RESULTS: Constant comparative analysis identified three themes common to the experience of transitioning to hospice: (1) caregivers' acceptance of the impending death, (2) challenges in negotiating the health care system across the continuum of care, and (3) changing patient-family dynamics. SIGNIFICANCE OF RESULTS: Identification of these themes from the caregivers' perspective generates hypotheses about potential delays in hospice and may ultimately be useful in the design of interventions that are consistent with caregivers' needs.
2004

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

Pages

351-360

Issue

4

Volume

2

Citation

Schulman-Green D; McCorkle R; Curry L; Cherlin E; Johnson-Hurzeler R; Bradley E, “At the crossroads: making the transition to hospice,” Pediatric Palliative Care Library, accessed December 3, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12981.

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