Variation in Hospice Experiences by Care Setting for Patients With Dementia.
Layla Parast, Anagha A Tolpadi, Joan Teno and 2 others
PMID 35430207WHAT IT FOUND
Caregivers reported worse hospice experiences in nursing homes, assisted living, and hospitals than at home.
Pain help was rated highest; help for anxiety and sadness was rated lowest. Significant variation existed between individual hospices within every setting.
Key findings
01Quality of care scores were consistently lowest for patients in nursing homes, assisted living facilities, and acute care hospitals compared to home or inpatient hospice units.
02Help for symptoms was rated better for pain than for emotional distress, with anxiety and sadness receiving the lowest scores.
03There was wide variation in quality scores between individual hospice agencies, even when comparing hospices within the same care setting.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relied on the hospice's recorded primary diagnosis, so patients with dementia as a secondary condition were not included. Results reflect experiences before the COVID-19 pandemic, which changed hospice operations. The survey only captures the perspective of the primary caregiver, which may miss other family members' experiences. Data was limited to respondents, potentially introducing nonresponse bias.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the lower scores in nursing homes as evidence that the facility staff provided poor care. The survey measures the hospice agency's performance, and the data does not separate the impact of the physical setting from the hospice team's delivery of services.