The Crisis of US Hospice Care

Braswell, Harold

doi:10.1353/book.67474

Cited by 7 publications

(7 citation statements)

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“…6,[14][15][16][17] Historically, the term social model hospice home has been inconsistently used by those inside and outside of the movement. 7,[9][10][11][12] Currently, there is a greater consensus on the meaning of the term by those advocating for the delivery model through a national membership organization called the Omega Home Network. 18 However, outside this organization, the term is used irregularly to define a range of services, as traditional medical hospice models, regulatory and community agencies, and the health care system in general have variable understanding of the term social model hospice home.…”

Section: Methodsmentioning

confidence: 99%

“…Using a qualitative approach, this publication highlights the greater opportunity for personal and spiritual growth in dying made possible in the communal setting. As a primary goal to provide dying persons with appropriate care, Braswell 9 furthers the work by introducing the terminology of a social model of terminal illness in which death is defined as natural, rather than as the ultimate loss in the battle against illness. Subsequently, Sunday's 11 book chapter melds these previous writings and outlines the key attributes of the SMHh concept as they exist in Sarah House and its association with kindness during end of life.…”

Section: Attributesmentioning

confidence: 99%

“…Efforts to conceptualize this community endeavor have resulted in the term social model hospice home (SMHh). 7,[9][10][11][12] The purpose of this review is to explore the evolution of the concept of the SMHh within the paradigm of EOLc and confirm a formal definition of the concept as an innovative model of health care delivery.…”

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confidence: 99%

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Social Model Hospice Home

Farrar

Scott

Clifton

et al. 2021

J Hosp Palliat Nurs

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Section: Methodsmentioning

confidence: 99%

Section: Attributesmentioning

confidence: 99%

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Social Model Hospice Home

Farrar

Scott

Clifton

et al. 2021

J Hosp Palliat Nurs

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“…59,62 Thoughtful design of care plans, communication guides, and care coordination support for concurrent care programming may facilitate access in hospices with fewer personnel. Clinical models of concurrent care delivery are nascent and often driven by dedicated clinician advocates.…”

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confidence: 99%

Concurrent Care as the Next Frontier in End-of-Life Care

Ernecoff,

Anhang Price

2023

JAMA Health Forum

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ImportanceHospice care is a unique type of medical care for people near the end of life and their families, with an emphasis on providing physical and psychological symptom management, spiritual care, and family caregiver support to promote quality of life. However, many people in the US who could benefit from hospice have very short stays or do not enroll at all due to current hospice policy. Changing policy to allow for concurrent availability of disease-directed therapy and hospice care—known as concurrent care—offers an opportunity to increase hospice use and lengths of stay.ObservationsUnder Medicare payment policy, hospices are responsible for covering all costs related to patients’ terminal conditions under a per diem rate. This payment structure has led to a de facto requirement that patients forgo costly therapies (including life-prolonging treatments or those with palliative intent) on enrollment in hospice because they are prohibitively expensive. In other countries, in Medicaid for children, and in the Veterans Health Administration in the US, there is greater flexibility in providing hospice services alongside life-prolonging care. Often paired with innovative payment models, concurrent care smooths practical, psychological, and physical care transitions when patient goals prioritize comfort. For example, allowing simultaneous receipt of hospice care and dialysis for people living with end-stage kidney disease—a group with relatively low hospice enrollment—can act as a bridge to hospice and potentially promote longer lengths of stay.Conclusions and RelevanceMedicare and health care delivery systems are increasingly testing payment and care delivery models to improve hospice use via concurrent care, offering an important opportunity for innovation to better meet the needs of people living with serious illness and their families.

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“…4 In contrast, entry criteria for the the MHB-which was established in 1982 with the goal of providing a cost-effective alternative to usual care primarly for Medicare beneficiaries dying from cancer-were extremely restrictive. 5 Over time, the ESKD program has grown beyond all expectations and now caters to a large number of medically complex and debilitated older adults, 6 many of whom could benefit from hospice services as they approach the end of life. However, rigid and outdated hospice eligibility criteria grounded in an artificial dichotomy between curative and palliative care mean that most patients undergoing dialysis never receive hospice services or enroll only when they are ready to stop, or too sick to continue, dialysis treatments.…”

mentioning

confidence: 99%