"The Crossover to Hospice": Perspectives of Home Healthcare Nurses and Social Workers. (June 2023)

• Record Type: Journal Article
• Authors: Osakwe, Zainab Toteh; Oni-Eseleh, Ohiro; Rosati, Robert J.; Stefancic, Ana
• Is Part Of: American journal of hospice & palliative care. Volume 40:Number 6(2023)
• Page Start: 613
• Page End: 619
• Publication Date: 2023-06
• Subjects: hospice -- end-of-life decision making -- qualitative -- home health care -- nurses -- social workers; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/10499091221123271
• Languages: English
• ISSNs: 1049-9091

Abstract

Background: Although home healthcare(HHC) clinicians increasingly provide care to a homebound population with advanced illness and high symptom burden, we know little about how HHC clinicians navigate discussions about hospice with patients and families in this setting. Objective: We sought to explore perspectives on transition from HHC to hospice among HHC nurses and social workers. Design: PQualitative study using semi-structured interviews and thematic analysis. Results: Fifteen nurses and 3 Social workers participated in the study. Four main themes emerged from the interviews: (1) Regulatory Forces of Hospice and HHC; (2) Structure of HHC; (3) Individual beliefs—Hospice means giving up; and (4) Dynamics of Communication in HHC to Facilitate Transitions to Hospice. Conclusion: Introducing the option of hospice to patients and families nearing end-of-life in the HHC setting is complex and challenging. Facilitators of hospice discussions in the HHC setting include interdisciplinary team-based clinical review, clinical decision support tools to identify patients who are hospice-eligible, and staff training. These factors provide targets for future interventions.