Telling the Story: Perceptions of Hospice in Long-Term Care
ABSTRACT We used qualitative methods (13 homogenous focus groups of residents, bereaved family members, licensed staff, paraprofessional staff, and social workers) to examine the components of a good death in a long-term care (LTC). Hospice involvement as beneficial to end-of-life care emerged as a naturally occurring theme and hospice was deemed as expert in all groups. Participants indicated some barriers to hospice involvement as well as difficulties in collaboration between facility staff and hospice personnel. When viewed within the context of existing literature, these data suggest that a new model of hospice care in which hospice staff serve as expert consultants may be appropriate. This model that recognizes and optimizes the experience of both the facility staff and hospice personnel will benefit care recipients.
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ABSTRACT: As the prevalence of dementia continues to grow, informal caregivers face unique challenges as they approach the end of life, and access to support and palliative care is often limited. I used a phenomenological approach to explore the experiences of caregivers actively seeking formal end-of-life care, in particular hospice care, for a loved one with dementia. In-depth interviews with 11 caregivers about 14 patients revealed five themes, including: setting the stage for heartbreak, reaching the boiling point, getting through the front lines, settling for less, and welcoming death. Nurses must recognize the complex needs of caregivers, educate caregivers on the disease process, and adjust to palliative goals sooner to meet the needs of caregivers. Prevalence of these issues must be further examined through quantitative study to evaluate the need to reconsider current hospice eligibility criteria based on prognosis.Qualitative Health Research 07/2014; 24(9). DOI:10.1177/1049732314545888 · 2.19 Impact Factor