Palliative Care Experience in the Last 3 Months of Life: A Quantitative Comparison of Care Provided in Residential Hospices, Hospitals, and the Home From the Perspectives of Bereaved Caregivers.
Daryl Bainbridge, Hsien Seow
PMID 28610431WHAT IT FOUND
89% of bereaved caregivers rated hospice care as excellent, much higher than home, hospital, cancer center, or physician care.
They also rated hospice nursing and personal care help better in the last week.
Key findings
0189% of caregivers rated hospice care as excellent, compared with 39% for home care, 52% for the most responsible physician, 42% for a cancer center, and 33% for hospital.
02In the last week of life, hospice as the main setting was rated significantly better for help with personal care, nursing care, privacy, and all four support domains.
03Most of the worst transitions between care settings involved moving to or from hospital (74%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Caregivers, not patients, reported the care experience. The survey was only in English, so non-English speakers are probably underrepresented. Only 1153 of 2604 approached caregivers responded, and respondents may have more extreme positive or negative views than nonrespondents. The study did not control for length of hospice stay or intensity of care in other settings. It also lacked clinical data explaining hospice timing or response differences. Eight Ontario hospices did not participate, and some had different populations or disease focus. The findings reflect Ontario hospice access and may not apply where home or hospital palliative care is more consistent.
Declared interests
The authors declared no potential conflicts of interest. No funding source is stated.
The easy way to misread this
Do not conclude that hospice care causes better outcomes. These are retrospective caregiver ratings, not patient outcomes or clinical quality measures, and the study did not control for length of stay or care intensity.