The needs and supportive networks of the dying: An assessment instrument and mapping procedure for hospice patients

Abstract

If institutional systems that provide end-of-life care are to survive the demands of managed care, they will need to tie together methods of assessing the needs of the dying, leading to a new understanding of the functioning of a patient's existing helping networks. This paper presents the preliminary findings of a research project conducted at a Midwest hospice. The study utilized a cross sectional correlational survey of patients' needs via the Early Risk and Resiliency Inventory (ERRI), while mapping their helping networks with a Circles of Care Ecomap. It addressed the question, "What is the relationship between the needs of the dying and the formal and informal support provided?" Study findings supported the contention that higher need patients utilized the more expensive institutional services rather than relying on available natural networks; and statistical analysis of the study instrument suggested the creation of a new conceptual domain of psychospiritual need.

Ecomapping: an innovative research tool for nurses

“…Early et al. (2000) used a modified ecomapping process in social work practice to identify the relationship between the needs of people who were dying and the formal and informal support provided.…”

Relational Competence Theory

“…Several editions of the EcoMap have been proposed (Calix, 2004;CarpenterAeby, Aeby, & Boyd, 2007;Hodge, 2000;Ray & Street, 2005;Early, Smith, Todd, & Beem, 2000) according to different objectives and observation levels. All these contributions remain within the range of only qualitative evaluations.…”

Patient approaches to clinical conversations in the palliative care setting

“…Although extended research literature in palliative care exists, it focuses on medical roles in decision‐making, ‘do not resuscitate orders’ (Voltz et al. 1998), durable power of attorney and living wills (Early et al. 2000), issues patients take into account while making a decision, and the psychology of decision‐making (Biley 1992).…”

“…However, fear of possible confrontation with nurses, especially where they are seen as the ‘experts’, poses frequent problems for patients in voicing their views. When afraid of repercussions or uncertain about their future, patients may be reluctant to engage in making decisions (Early et al. 2000).…”