Live hospice discharge: Experiences of families, and hospice staff.
Margaret F Clayton, Rebecca Utz, Eli Iacob and 6 others
PMID 33454147WHAT IT FOUND
Families and hospice staff described involuntary live discharge as distressing.
They reported continued need for nursing care, aide support, equipment and medications. Staff said early, transparent planning was needed, but nurse aides often learned of discharge last.
Key findings
01Of 5,648 hospice admissions between 2013 and 2017, 14% (795 patients) were discharged alive.
02Families valued hospice care but reported distress and continued need for hospice services after live discharge.
03Staff said live discharge should be methodical and not come as a surprise, while nurse aides often learned of discharge last.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The prevalence data come from a not-for-profit hospice agency with nine regional offices, so the 14% live discharge rate may not apply to other agencies. The narrative sample was small: five family caregivers and six hospice staff, including three nurse aides, two nurses and one administrator. The study reports experiences and administrative counts, not patient outcomes or tested interventions. Family caregivers spoke about patients; the paper does not report interviews with patients themselves. The qualitative themes are descriptive and do not show that early discharge planning or nurse-aide notification improves care.
Declared interests
The supplied publication types list non-U.S. government research support. The article text does not state a funder role or author conflicts.
The easy way to misread this
Do not read the 14% live discharge rate as a national rate. The data come from a not-for-profit hospice agency, and the study does not test whether proactive discharge planning improves outcomes.