 At the Eleventh Hour: Psychosocial dynamics in short hospice stays This study explores the psychosocial dynamics of hospice stays less than 2
weeks of patients aged 65 and older with cancer. Fifty-nine caregivers of 50
patients were audiotaped, transcribed, and coded. A late diagnosis (44%) was
categorized as one in which cancer was diagnosed between 2 and 4 weeks before
the patient's death, rendering earlier hospice admission impossible. Late diagnoses
were made because the cancer was missed, masked by comorbidities, or the person
resisted seeing a healthcare provider. A known diagnosis (50%) was one in which
the diagnosis was made long before hospice admission; admission was delayed
because the person elected ongoing curative treatment until the final days of
life, or the family managed the care without hospice until a turning point occurred,
making the care unmanageable. The implications of this study are that hospice
utilization is influenced by patient-family-provider factors. Healthcare professionals
need to understand the characteristics and needs of subgroups of terminally
ill people in order to provide good end-of-life care. Waldrop DP. Adapted from
Gerontologist. 2006 Feb;46(1):106-114. |
| Department of Pain Medicine and Palliative Care Beth Israel Medical Center, New York City ©2005 Continuum Health Partners, Inc. www.stoppain.org/palliative_care |
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