Nursing home experience with hospice.
OBJECTIVE
Much has been written regarding the problems of terminally ill people residing in nursing homes. Hospice care is one option these facilities have to assist in managing dying patients. The purpose of the study was to explore the knowledge base, experience, and attitudes of nursing home management with and toward hospice care.


METHODS
A descriptive study that involved phone interviews of a systematic random sample of management personnel in nursing homes to explore their experiences with hospice care.


METHODS
Nursing homes.


METHODS
60 administrators and directors of nursing (DON) from 42 nursing homes in Missouri.


METHODS
Measurements included overall experience with hospice, the benefit of hospice to residents, specific experiences with hospice service, knowledge of hospice regulation and reimbursement, and perception of pain assessment skills.


RESULTS
Results show that management personnel believe that hospice was positive and valuable for residents. Concerns included the frequency and availability of hospice services for nursing home residents, especially in rural areas. Nursing home management claimed that hospice was knowledgeable in pain management, yet when measured, pain management skills ranked 2.1 on a scale of 1 to 5 (1 being the best). Community and physician understanding of hospice was identified as a major barrier for residents.


CONCLUSIONS
While the results indicate a positive overall experience, a number of shortcomings are identified. The study points to opportunities for improvement in hospice/nursing home relationships. It also identifies opportunities for hospices and nursing homes to educate their medical directors in an effort to obtain active participation in the identification of patients for palliative care. In addition, the need for medical directors to assist in the education of nursing home staff regarding hospice services and benefits is indicated. Specifically, medical directors can educate nursing home staff on care plan responsibilities with hospice patients and other regulatory issues.
Parker-Oliver
Debra
D
University of Missouri, School of Social Work, Columbia, Missouri 65211, USA.
Bickel
Denise
D