How Does the Timing of Hospice Referral Influence Hospice Care in the Last Days of Life? 

Annotated bibliographies on the perceived impacts of Hospice

Casernes, J. (2001). Does Hospice have a role in Nursing Home Care at the End-of-life? Journal of the American Geriatrics Society, 49:1493-1498

This is a preliminary case study that that delves into the pros and cons of hospice involvement in a nursing home through analysis of the clinical database of two thousand patients who are above 64years. Of the sample study, 182 were residing in the nursing homes and the rest resided in the outside community. The author points out to the nursing homes and hospices works in a symbiotic relationships. The residents who sought hospice care earlier were accorded better service. The future lies in public awareness to face death in a clinical setting.

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Jones, B. & Boyle, D. (1997).Differential Utilization of Hospice Services in Nursing Homes. The Hospice Journal; 12(3): 41-57

The author uses an evaluation paradigm to advance his reasoning. He notes that nursing home administrators with negative perception of hospice care in their facilities were unlikely to advocate for its use given the concerns of the administration. The survey was carried on 25 nursing homes and it established that in nursing homes where the administration was accommodative to hospice care, it was mostly used to treat the patients. The concern of some administrators were that: it was considered supplementary care to nursing as they do not prioritize in caring for the dying, lack of recognition for standard bureaucracies and expenses associated with hospice, it was too close to euthanasia  and the biggest spender would be the patients. The author proposes a strategic management team for mediating contracts that touch on administrators’ worries. It however appreciates that it gives the patient clinical setting service before death.

Miller, S. & Brunner, B. (2007). How Does the Timing of Hospice Referral Influence Hospice Care in the Last Days of Life? Journal of the American geriatrics Society 51:6; 798-806

This a study of the patients enrolled in hospice and the determinants of the kind of hospice that they received in their last moments of life, particularly how the timing shaped the continuous use of hospice home care and inpatient hospice care. The sample was about 28,423 hospice patients from the same hospice provider who designed seven programs covering seven states. The observations proved that patients on the verge of death do not continuously use hospice home care.  The probability of passing away under inpatient hospice care is higher for patients referred from hospitals and those referred when on the verge of death. In future, it realizes that the demand for physicians and caretakers will escalate more than the ability to provide for these services. To solve this, innovative care units have introduced new technologies of providing service beyond the walls of hospitals through tele consultations and telemedicine.

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