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Gerontologist. 2006 Feb;46(1):106-14.

At the eleventh hour: psychosocial dynamics in short hospice stays.

Author information

1
University at Buffalo School of Social Work, 633 Baldy Hall, Box 601050, Buffalo, NY 14260, USA. dwaldrop@buffalo.edu

Abstract

PURPOSE:

This study explored the psychosocial dynamics of short hospice stays (less than 2 weeks) of cancer patients age 65 and older.

DESIGN AND METHODS:

In-depth interviews with 59 caregivers of 50 patients were audiotaped, transcribed, and coded by using Atlas ti software.

RESULTS:

A descriptive typology is presented. A late diagnosis (n = 22 or 44%) was one in which cancer was diagnosed between 2 and 4 weeks before death, rendering earlier hospice admission impossible. Late diagnoses were made because the cancer was missed, masked by comorbidities, or the person resisted seeing a health care provider. A known diagnosis (n = 25 or 50%) was one in which the diagnosis was made long before hospice admission; admission was delayed because the person elected ongoing curative treatment until the final days of life, or the family managed the care without hospice until a turning point (medical, functional, pragmatic, or emotional) occurred, making the care unmanageable.

IMPLICATIONS:

Hospice utilization is influenced by the interrelationship among patient-family-provider factors. Understanding the characteristics and needs of subgroups of terminally ill people is key to providing good care at life's end.

PMID:
16452290
[Indexed for MEDLINE]
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