A retrospective study of patient care needs on admission to an inpatient hospice facility

The care and support of dying patients and their families are among the most important skills of a family physician. In this century, an increasing proportion of deaths have occurred in hospitals with resulting medicalization of the dying process. Hospice care has emerged to focus on the relief of suffering rather than the cure of illness. This descriptive study reports information about the diagnoses, care needs, and attending physicians of a cohort of patients admitted to a free-standing, inpatient hospice program.

We undertook a retrospective chart review of 335 patients admitted to a hospice program during a 26-month period, collecting data recorded on standardized nursing assessment forms. These forms provided information on 19 biologic, functional, and psychosocial symptom groups at the time of admission.

Family physicians were the admitting physicians in a minority of hospice admissions. Pain and mobility problems were the most frequent symptoms encountered. Other common issues included bowel, respiratory, and nutritional problems. Emotional difficulties were noted less frequently than these common biomedical problems.

Family physicians should be trained to address core problems encountered in the care of dying patients. Multidisciplinary team approaches are essential in the management of many problems encountered in hospice care.