Social and Organizational Practices that Shape Hospice Utilization in Nursing Homes

• In Event: 3422 - Section on Aging and Life Course Refereed Roundtable Session
  In Refereed Roundtable 100min: Table 05. Healthcare

Abstract

Although hospice utilization has grown rapidly, there is wide variation in hospice usage among nursing homes. This study examines the social and organizational practices that shaped hospice utilization in two nursing homes, one in which 76% of residents died on hospice and one in which 24% did. Staff at both identified familial and financial challenges to getting hospice for residents. At the high-hospice facility, staff lauded hospice as additional care that went beyond what they could provide, while at the low-hospice facility, a significant group of staff claimed an essential sameness between hospice and their in-house palliative care. Furthermore, the high-hospice facility proactively approached families about hospice when clinically appropriate, whereas the low-hospice facility took a reactive approach, discussing hospice if families asked about it. Findings highlight how staff attitudes and practices towards hospice shape end-of-life nursing home care.

Author

• Jason Rodriquez, University of Massachusetts-Boston