Characterization of an Acute Inpatient Hospice Palliative Care Unit in a U.S. Teaching Hospital

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A hospice/palliative medicine consultation team was formed in July 1993 in a U.S. teaching hospital to provide patient care and education. The team consists of an attending physician, nurse, fellow, and any residents or medical students rotating on the service. More than 500 consultations are received each year. Beginning in January 1995,108 consecutive referrals to the service were assessed using a standard form completed by the nurse. The average age was 62 years. The gender of patients was 58% male and 42% female. At the time of consultation 87% were hospitalized on general medical services (including hematology/oncology), 4% were on surgical services, 3% on the neurology service, and 6% were in an intensive care unit. Cancer was the primary diagnosis in 52%, AIDS in 24%, with the rest being distributed among cardiac, renal, pulmonary, neurologic, and other diseases. The most prominent physical symptoms were 48% weakness/malaise, 44% pain, 28% dyspnea, and 23% agitation/confusion. The average length of time patients were followed was 2 days (range 1-10). We conclude that a hospice/palliative medicine consultation service sees a broad range of patients and problems and is a rich resource for teaching hospice and palliative medicine.

Section: Results From Patient/family Surveys Indicatementioning

confidence: 99%

“…The hospital has its own home hospice agency (established in 1982) and a 12-bed acute inpatient hospice/palliative care unit (established in 1986). 5 The consultation service, acute inpatient unit, and home hospice agency are administered as a single program. The hospital also has its own home health agency affiliate.…”

Section: Introductionmentioning

confidence: 99%

Prospective Evaluation of Referrals to a Hospice/Palliative Medicine Consultation Service

Gunten

Camden

Neely

et al. 1998

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“…In addition, the PCU utilizes resources, such as massage and art therapy, that may not be available on general medical wards regardless of PCCS involvement in care. 23 The PCU also provides an aesthetic and quiet setting that may contribute to greater family member satisfaction. We offer several potential explanations for the fact that we found no difference in satisfaction between the PCCS and UC groups.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Bereaved Family Members To Assess Quality of Care on a Palliative Care Unit

Roza

Lee

Meier

et al. 2015

“…For this reason, specialized units where patients and families can be assured of the environment and the skilled care they need have been developed in many institutions. 48,49 …”

Section: Dying In Institutionsmentioning

confidence: 99%

Competency in End-of-Life Care: Last Hours of Life

Ferris

Gunten

Emanuel

2003

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Clinical competence, willingness to educate, and calm and empathic reassurance are critical to helping patients and families in the last hours of living. This review adapted from the Education for Physicians on End-of-Life Care (EPEC) Curriculum describes the predictable course that occurs as well as approaches to management. Management principles are the same at home or in a health care institution. However, death in an institution requires accommodations to assure privacy, cultural observances, and communication that may not be customary. In anticipation of the event, it helps to inform the family and other professionals about what to do and what to expect. Care does not end until the family has been supported with their grief reactions and those with complicated grief helped to get care. Care at the end of life is a core competency.