title: Same agency, different teams: perspectives from home and inpatient hospice care.
abstract: Tremendous growth in hospice over the past 30 years in the United States has increased the number of terminally ill patients dying at home. Recently, however, more hospice patients are dying at inpatient facilities. To understand the varying perceptions about care in the home and inpatient hospice, we conducted semistructured interviews with 24 interdisciplinary team (IDT) members and analyzed the data using the constant comparative method. Core interdisciplinary tasks, including identifying the focus of energy, tailoring family caregiver involvement, acknowledging who is in charge, and knowing both sides differed in the home and inpatient settings. Despite the overarching umbrella of hospice care, home and inpatient hospice settings create different foci for IDT members, burdens and privileges for family caregivers, and control of the care plan. Key differences between home and inpatient hospice processes of care highlight the complexity of patient-centered end-of-life care in the United States.
authors.affiliation: North Shore Medical Center, Salem, Massachusetts, USA slysaghthurley@alumni.upenn.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Lysaght Hurley
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Neville
authors.initials: N
authors.lastname: Strumpf
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Ersek
mesh_terms: D000884:Anthropology, Cultural; D017028:Caregivers / Q000523:psychology*; D006699:Home Care Services / Q000458:organization & administration*; D017051:Hospice Care / Q000458:organization & administration* / Q000523:psychology*; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D010348:Patient Care Team / Q000458:organization & administration; D024382:Professional Role; D013727:Terminal Care / Q000458:organization & administration / Q000523:psychology; D014481:United States
keywords: death and dying; end-of-life issues; health care professionals; nursing, palliative care; palliative care; qualitative