Many people have told me that they didn’t know hospice care exists in nursing homes. Even more would probably be surprised to know that it also exists in assisted living facilities (ALFs). I can’t emphasize enough that hospice care is available no matter where a person lives.
Reported in the “Gerontologist,” a study of hospice care in assisted living facilities was done to get detailed descriptions of end-of-life care provided by ALF medication aides, caregivers, nurses, and hospice nurses in urban and rural settings. Interviews were used to gather information. Having worked as a hospice volunteer in urban nursing homes for several years, I was interested in the results. They were very similar to what I would have expected from an urban nursing home or any other institutional care:
1) The quality and nature of resident-staff and assisted living-hospice staff relationships are critical in promoting good end-of-life care for ALF residents.
2) Length of the resident's stay in the facility and how well staff knew the resident were associated with the quality of the resident-staff relationship.
3) Respectful collaboration, clear communication, use of complementary knowledge and skills of staff, and shared expectations about the care were associated with positive staff relationships.
4) ALF administrative support for hospice patients was important.
Basically, ALFs and hospice organizations that are committed to working together with hospice programs must both support staff, patients, and families. If this sounds like an obvious conclusion, it is. Unfortunately, it is a reality that is still unrealized too often. There is a need for more successful models of this partnering system of care at both nursing homes and ALFs. From my own observations in nursing homes, especially regarding staff turnover, I know that the non-curative philosophy of hospice care requires ongoing staff inservice and monitoring to be implemented successfully.
This video relates the positive and negative transition concerns of an elderly man (age 95) moving to an assisted living facility.
Frances Shani Parker, Author
its must have the quality and nature of resident-staff and assisted livinghospice relationships are critical in promoting good end-of-life care residents.
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