Hospice care provides many benefits to terminally ill patients, including improving quality of life and reducing the burden of symptoms, yet fewer than half of those who die while on Medicare are actually using hospice services. Of those who choose hospice services, the median length of stay is 24 days, much less than the three months recommended by the National Hospice and Palliative Care Organization.
A team led by Dr. Alexis Kirk, a graduate of the University of North Carolina Gillings School of Global Public Health, aims to change these trends with an intervention to improve the timeliness of hospice referrals.
A paper on the team’s findings, “Pilot Test of an Adapted Intervention to Improve Timeliness of Referrals to Hospice and Palliative Care for Eligible Home Health Patients,” was published online by the Journal of Palliative Medicine.
The team adapted an intervention originally used to refer nursing home residents to hospice for use with the home health population. Nurses involved in the study then administered screening questions to eligible patients (or their caregivers) during an in-person home health visit; reported screening results to the patient/caregiver (if the patient screened positive); and, if authorized, initiated appropriate referral.
Of the 28 patients who participated in the intervention, 27 screened positive for potential hospice appropriateness. Of those 27 patients, three entered palliative care and one chose to enter hospice.
While the study found that patients are willing to discuss their care needs, goals and preferences, the fact that 23 of 27 patients who screened positive did not consider using hospice/palliative care makes it clear that other considerations factor into decisions about end-of-life care.Friday Letter Submission, Publish on August 02