title: Hospice Services for Complicated Grief and Depression: Results from a National Survey.
abstract: OBJECTIVE
  To describe the prevalence of screening for complicated grief (CG) and depression in hospice and access to bereavement therapy and to examine whether screening and access to therapy varied according to hospice organizational characteristics or staff training and involvement.
  
  
  METHODS
  Cross-sectional national survey conducted from 2008 to 2009.
  
  
  METHODS
  United States.
  
  
  METHODS
  Hospices (N = 591).
  
  
  METHODS
  Whether hospices screened for depression or CG at the time of death or provided access to bereavement therapy (individual or group). Organizational characteristics included region, chain status, ownership, and patient volume. Staffing-related variables included training length and meeting attendance requirements.
  
  
  RESULTS
  Fifty-five percent of hospices provided screening for CG and depression and access to bereavement therapy, 13% provided screening but not access to bereavement therapy, 24% provided access to bereavement therapy but not screening, and 8% neither screened nor provided access to bereavement therapy. Hospices with 100 patients per day or more were significantly more likely to provide screening and access to bereavement therapy.
  
  
  CONCLUSIONS
  Hospices appear to have high capacity to provide screening for CG and depression and to deliver group and individual therapy, but data are needed on whether screeners are evidence based and whether therapy addresses CG or depression specifically. Future work could build upon existing infrastructure to ensure use of well-validated screeners and evidence-based therapies.
authors.affiliation: Brookdale Center for Health Aging, Hunter College, City University of New York, New York, New York.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Ghesquiere
authors.affiliation: Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Aldridge
authors.affiliation: Connecticut Hospice and the Hospice Institute for Education, Training and Research, Branford, Connecticut.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Johnson-Hürzeler
authors.affiliation: Department of Psychiatry, Graduate School of Medical Sciences, Weill Cornell Medical College, White Plains, New York.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaplan
authors.affiliation: Department of Psychiatry, Graduate School of Medical Sciences, Weill Cornell Medical College, White Plains, New York.|Clinical Epidemiology Program, Graduate School of Medical Sciences, Weill Cornell Medical College, White Plains, New York.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
authors.affiliation: Global Health Initiative, Yale University, New Haven, Connecticut.|Global Health Leadership Institute, Yale University, New Haven, Connecticut.|Branford College, Yale University, New Haven, Connecticut.|School of Public Health, Yale University, New Haven, Connecticut.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bradley
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006117:Grief; D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000458:organization & administration / Q000592:standards; D017051:Hospice Care / Q000379:methods / Q000592:standards; D006738:Hospices / Q000379:methods / Q000458:organization & administration; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D015995:Prevalence; D013192:Staff Development / Q000458:organization & administration; D014481:United States / Q000453:epidemiology
keywords: bereavement; complicated grief; depression; family caregivers; hospice