Palliative care in hospital, hospice, at home: results from a systematic review

Finlay, Ilora; Higginson, Irene J; Goodwin, David; Cook, Alison; Edwards, Adrian; Hood, Kerenza; Douglas, Hannah; Normand, Charles

doi:10.1093/annonc/mdf668

Cited by 146 publications

(115 citation statements)

References 40 publications

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“…The findings from our study exemplify prior presumptions of residential hospices as being centers of excellence in palliative care (Addington-Hall & O'Callaghan, 2009;Finlay et al, 2002;Grande et al, 2003). Most caregivers were expressive of the positive effect that the hospice had on death.…”

Section: Discussionsupporting

confidence: 88%

The care experiences of patients who die in residential hospice: A qualitative analysis of the last three months of life from the views of bereaved caregivers

et al. 2017

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Objective: Despite the increasing prominence of residential hospices as a place of death and that, in many regards, this specialized care represents a gold standard, little is known about the care experience in this setting. Using qualitative survey data, we examined the positive and negative perceptions of care in hospices and in other prior settings.Method: Qualitative comments were extracted from the CaregiverVoice survey completed by bereaved caregivers of decedents who had died in 16 residential hospices in Ontario, Canada. On this survey, caregivers reported what was good and bad about the services provided during the last three months of life as separate open-text questions. A constant-comparison method was employed to derive themes from the responses.Results: A total of 550 caregivers completed the survey, 94% (517) of whom commented on either something good (84%) and/or bad (49%) about the care experience. In addition to residential hospice, the majority of patients represented also received palliative care in the home (69%) or hospital (59%). Overall, most positive statements were about care in hospice (71%), whereas the negative statements tended to refer to other settings (81%). The hospice experience was found to exemplify care that was compassionate and holistic, in a comforting environment, offered by providers who were personable, dedicated, and informative. These humanistic qualities of care and the extent of support were generally seen to be lacking from the other settings.Significance of results: Our examination of the good and bad aspects of palliative care received is unique in qualitatively exploring palliative care experiences across multiple settings, and specifically that in hospices. Investigation of these perspectives affirmed the elements of care that dying patients and their family caregivers most value and that the hospices were largely effective at addressing. These findings highlight the need for reinforcing these qualities in other end-of-life settings to create comforting and supportive environments.

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Section: Discussionsupporting

confidence: 88%

The care experiences of patients who die in residential hospice: A qualitative analysis of the last three months of life from the views of bereaved caregivers

et al. 2017

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“…4,25,29,30 In the context of high mortality, resource utilization, and financial burdens to patients' families, discussions about a patient's future quality of life and withdrawal of life support are becoming more common both in the United States and across the globe. 6,[31][32][33][34] End-of-life care in the ICU has become an integral component of contemporary critical care practice. 35 Providing such care requires technical competence, excellent communication skills, emotional and cultural sensitivity, and a desire for shared decision making.…”

mentioning

confidence: 99%

The Going Home Initiative: Getting Critical Care Patients Home With Hospice

Lusardi

Jodka

Stambovsky

et al. 2011

Critical Care Nurse

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Although considerable effort is being directed at providing patients and their families with a “good death,” most patients in intensive care units, if given the choice, would prefer to die at home. With little guidance from the literature, the palliative care committee of an intensive care unit developed guidelines to get patients home from the intensive care unit to die. In the past few years, the unit has transferred many patients home with hospice care, much to the delight of their families. Although several obstacles to achieving this goal exist, the unit has achieved success in a small-scale implementation of its Going Home Initiative.

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“…Timely access to palliative care services is an issue raised by a number of authors (Carter, McKinlay, Scott, Wise, & Mcleod, 2002;Finlay et al, 2002;Heilig, 2003;Massarotto, Carter, MacLeod, & Donaldson, 2000;Murray, Grant, Grant, & Kendall, 2005). In America, only 20-30% of people who are dying are receiving hospice services (Heilig, 2003), and as we discuss below, minority cultural groups in particular often do not access palliative care.…”

Section: Palliative Carementioning

confidence: 95%

A Community Approach to Palliative Care: Embracing Indigenous Concepts and Practices in a Hospice Setting

Cottle¹,

Hughes²,

Gremillion³

2013

Journal of Systemic Therapies

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This article documents a community approach to palliative care that took place inDrawing on a case study, this article describes some of the unique philosophies and practices of a hospice in Auckland, Aotearoa New Zealand whose staff aspire to work collaboratively and multi-systemically with their clients. 1 Community-based palliative care work is particularly important for Māori, the indigenous people of Aotearoa New Zealand, and for Pacific peoples, because these cultural groups often prefer to care for a dying family member in their home. The hospice-here given the pseudonym Outreach Care to preserve confidentiality for the case discussedserves an area with a large Māori and Pacific Island population. Hospice-based palliative care internationally aspires to engage a range of community services and approaches. However, in practice, the work is often dominated by a medical model that can individualize experiences of death and dying. Mackelprang and Mackelprang (2005) argue that social workers can ensure a broader perspective is taken

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Palliative care in hospital, hospice, at home: results from a systematic review

Cited by 146 publications

References 40 publications

The care experiences of patients who die in residential hospice: A qualitative analysis of the last three months of life from the views of bereaved caregivers

The care experiences of patients who die in residential hospice: A qualitative analysis of the last three months of life from the views of bereaved caregivers

The Going Home Initiative: Getting Critical Care Patients Home With Hospice

A Community Approach to Palliative Care: Embracing Indigenous Concepts and Practices in a Hospice Setting

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