In South Africa, 2

A questionnaire was mailed to 300 randomly selected hospices in the United States, to gather preliminary data on the nature of complementary therapy services provided by hospices. Information included types of complementary therapies offered, utilization, staffing, obstacles, as well as suggestions for improving hospice complementary therapy services. Of a total of 169 responding hospices, 60% offered complementary therapies to patients. The most popular therapies were massage therapy and music therapy. Only a portion of patients in these hospices received complementary therapy. Many hospices were limited in the amount of complementary therapy services they could provide because of program constraints, such as funding problems, lack of qualified complementary staff, inadequate knowledge of complementary therapies and how to offer these services, and resistance to complementary therapies by some staff and patients. A crucial challenge for hospices interested in providing complementary therapies to patients is to find ways to overcome these obstacles.

Introduction: Historically, bereavement services have been viewed as the “poor stepchild” within hospice programs. In 1986, a survey was conducted of hospices to examine the nature and function of hospice bereavement services. This article presents the results of a similar survey that was conducted in 2002. The aim of this study was to provide updated information on several aspects of hospice bereavement services including staffing, training, services provided, issues, and obstacles. Methods: A self-administered questionnaire, with items adapted from the 1986 study, was mailed to a random sample of 450 Provider Members of the National Hospice and Palliative Care Organization (NHPCO). The 23-item questionnaire took approximately 10 minutes to complete. There was a 58% return ( n = 260) of the questionnaires. Results: Hospices employed fewer bereavement personnel who served more bereaved individuals than compared to hospices in the 1986 study. Major obstacles were lack of time and too few bereavement staff. Bereavement programs tended to focus on less time intensive services such as mailings of letters and literature on grief versus phone calls and home visits. Bereavement staff expressed a desire to provide more groups and educational programs, as well as make more home visits, if they had more resources. Conclusions: Hospices are faced with difficult choices in an era of increased competition between hospices, insufficient reimbursement, and increased demands to document the effectiveness of services. Against this background, hospice bereavement services will continue to compete for attention and resources with other components of hospice programs.