Can short hospice enrollment be long enough? Comparing the perspectives of hospice professionals and family caregivers

Waldrop, Deborah P.; Rinfrette, Elaine S.

doi:10.1017/s1478951509000066

Cited by 20 publications

(20 citation statements)

References 31 publications

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“…6,[53][54][55] These findings are particularly relevant to health care professionals working in acute care settings. Recent U.S. data highlight a decrease in overall hospital deaths and an increase in hospice enrollment in the last month of life, tempered by an increase in ICU admission in the final month of life and hospice admission in the final three days of life.…”

Section: Discussionmentioning

confidence: 89%

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Higgins

Garrido

Prigerson

2015

Journal of Palliative Medicine

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Background: Cancer caregivers are key stakeholders in the final weeks of life and in bereavement. Research has highlighted end-of-life (EOL) factors important to caregivers, as well as factors contributing to caregiver mental health and bereavement outcomes. There has been limited data on factors predicting caregiver perceptions of quality of EOL care. Objective: This study's purpose was to identify modifiable predictors of caregivers' Caregiver Evaluation of Quality of End of Life Care (CEQUEL) scores, with the broader aim of informing clinical interventions to improve caregiver impressions of care and subsequent bereavement adjustment. Methods: Study data came from Coping with Cancer I (CwC1). CwC1 investigators interviewed advanced cancer patients and caregivers prior to the patient's death (Wave 1) and reinterviewed caregivers following the death (Wave 2) (N = 275 dyads). The authors identified potential Wave 1 predictors of CEQUEL scores and performed a series of linear regression analyses to identify a parsimonious predictive model using corrected Akaike's Information Criterion (AICc) values. Results: In adjusted analyses, caregivers rated quality of care as poorer when patients died in a hospital (B = -1.40, SE = 0.40, p = 0.001) (B, unstandardized regression coefficient; SE, standard error) or had less than one week of inpatient hospice care (B = -1.98, SE = -0.70, p = 0.006). Whole-person physician care and caregiver religiosity were associated with perceived higher quality of care in unadjusted, but not adjusted, analyses. Conclusions: Findings suggest that place of death and hospice length of stay best predict bereaved caregiver evaluations of quality of EOL care. These findings equip health care providers with modifiable targets to improve caregivers' experience of EOL care and subsequent bereavement.

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Section: Discussionmentioning

confidence: 89%

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Higgins

Garrido

Prigerson

2015

Journal of Palliative Medicine

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“…Among caregivers to older adults the most studied population has been caregivers to cognitively impaired care recipients, although other conditions have attracted increasing interest, such as cancer [47][48][49], stroke [2,45,[50][51][52][53][54], home-based dialysis [55], heart failure [56], multiple sclerosis [57][58][59], dementia [60], and amyotrophic lateral sclerosis (ALS) [61]. Caregiving research has also emerged from new geographical areas, including Japan [36,62,63], Taiwan [64], China [48,55], and so-called developing countries [65][66][67].…”

Section: The Current State Of Research On Caregivingmentioning

confidence: 99%

“Self-Employed” in Caregivinghood: The Contribution of Swedish Informal Caregivers’ Environmental and Contextual Resistance Resources and Deficits

et al. 2017

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Abstract:Informal caregivers provide the majority of care for older adults residing in their own homes. Caregivinghood, a new evidence-based concept, describes a time of life when relatives provide care at home. These caregivers need knowledge regarding resources to help them resolve the challenges they encounter. The theoretical framework underpinning this study is Antonovsky's salutogenic theory of health. This study had two aims: (1) to examine the salutogenic core concepts Generalized and Specific Resistance Resources and Deficits (GRRs/SRRs and GRDs/SRDs) described by Swedish informal caregivers as originating from the environmental and contextual domain of caregivinghood and (2) to discuss how this new knowledge might contribute to the development of health promotion initiatives. This qualitative and theory driven study used inductive and deductive data analysis. Data were gathered through salutogenically guided face-to-face interviews of 32 Swedish informal caregivers. In addition, the study relied on the salutogenic core concepts Specific and Generalized Resistance Resources and Deficits originating from their environment and context. Being in empowering surroundings reflects the presence of usable SRRs/GRRs, whereas Struggling in impeding surroundings reflects the presence of SRDs/GRDs. The results indicate that health-enhancing support has to be individualized (SRRs/SRDs) and generalized (GRRs/GRDs). This study's salutogenic approach and the methodology enhance the understanding of the mechanisms behind the development of Sense of Coherence. The results contribute both empirically and theoretically to strengthen health promotion research and practice when developing activities and support for caregivers in stressful situations, such as informal caregiving.

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“…The limited amount of studies using a salutogenic approach and qualitative design indicated that this procedure unraveled essential data concerning the caregiver situation in a way that another approach and design would probably not have accomplished (Cowley & Billings, 1999;Milberg & Strang, 2004, 2007Potgieter & Heyns, 2006;Pretorius, Walker, & Heyns, 2009;Waldrop & Rinfrette, 2009). Based on the use of salutogenesis in caregiving research, it was assumed that the salutogenic approach combined with an explorative mixed method research agenda (cf.…”

Section: Sense Of Coherence In Caregiving Researchmentioning

confidence: 99%

Using the salutogenic approach to unravel informal caregivers’ resources to health: Theory and methodology

Wennerberg

Lundgren

Danielson

2012

Aging & Mental Health

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Objectives: This article describes the theoretical foundation and methodology used in a study intended to increase knowledge concerning informal caregivers' resources to health (in salutogenesis; General Resistance Resources, GRRs). A detailed description of how the approach derived from salutogenic theory was used and how it permeated the entire study, from design to findings, is provided. How participation in the study was experienced is discussed and methodological improvements and implications suggested. Method: Using an explorative, mixed method design, data was collected through salutogenically guided interviews with 32 Swedish caregivers to older adults. A constant comparative method of analysis was used to identify caregiver-GRRs, content analysis was further used to describe how participation was experienced. Findings: The methodology unraveled GRRs caregivers used to obtain positive experiences of caregiving, but also hindrances for such usage contributing to negative experiences. Mixed data made it possible to venture beyond actual findings to derive a synthesis describing the experienced, communal context of the population reliant on these GRRs; Caregivinghood. Participating in the salutogenic data-collection was found to be a reflective, mainly positive, empowering and enlightening experience. Conclusion: The methodology was advantageous, even if time-consuming, as it in one study unravelled caregiverGRRs and hindrances for their usage on individual, communal and contextual levels. It is suggested that the ability to describe Caregivinghood may be essential when developing health-promoting strategies for caregivers at individual, municipal and national levels. The methodology makes such a description possible and suggested methodological improvements may enhance its usability and adaptability to other populations.

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Can short hospice enrollment be long enough? Comparing the perspectives of hospice professionals and family caregivers

Abstract: Hospice professionals and caregivers view late-stage admissions differently; they are a crisis for some but not all families. The development of a quick assessment tool for late-stage admissions has the potential for meaningful and effective intervention when time is of the essence.

Cited by 20 publications

References 31 publications

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

“Self-Employed” in Caregivinghood: The Contribution of Swedish Informal Caregivers’ Environmental and Contextual Resistance Resources and Deficits

Using the salutogenic approach to unravel informal caregivers’ resources to health: Theory and methodology

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