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Nursing home experience with hospice.
Debra Parker-Oliver1, Denise Bickel
1University of Missouri, School of Social Work, Columbia, Missouri 65211, USA.
Journal of the American Medical Directors Association
|June 17, 2003
Summary
Nursing home management views hospice care positively, but access and pain management skills need improvement. Enhancing collaboration and education can optimize end-of-life care for residents.
Area of Science:
- Gerontology
- Palliative Care
- Healthcare Management
Background:
- Nursing homes face challenges in providing end-of-life care.
- Hospice services offer a crucial support system for terminally ill residents.
- Understanding nursing home management's perspective on hospice is vital for improving care.
Purpose of the Study:
- To explore nursing home management's knowledge, experience, and attitudes toward hospice care.
- To identify barriers and facilitators in hospice and nursing home collaboration.
Main Methods:
- A descriptive study utilizing phone interviews.
- Systematic random sampling of 60 administrators and directors of nursing (DON) from 42 nursing homes in Missouri.
- Data collected on hospice experience, perceived benefits, knowledge of regulations, and pain management skills.
Main Results:
- Management perceives hospice care as positive and valuable for residents.
- Concerns exist regarding the frequency and availability of hospice services, particularly in rural areas.
- While management believes hospice is knowledgeable in pain management, measured skills ranked low (2.1/5); community and physician understanding emerged as barriers.
Conclusions:
- Despite positive overall experiences, shortcomings in hospice-nursing home relationships were identified.
- Opportunities exist to improve collaboration through education of medical directors and nursing home staff.
- Enhanced education on palliative care identification, care plan responsibilities, and regulatory issues is recommended.