Saturday, September 25, 2010

Successful Hospice-Nursing Home Partnerships (Research)

A hospice volunteer in Detroit nursing homes for many years, I am familiar with the benefits and problems that can occur when hospices and nursing homes operate as partners. These partnerships can work very well when certain best practices are followed. What do successful partnerships between hospices and nursing homes look like?

This study by Brown Medical School uses case studies of six nursing homes and hospices working collaboratively. Interviews were held with care providers and chief executive and financial officers regarding seven domains critical to successful collaboration. These were the results:

1) Nursing home-hospice collaborators were philosophically and otherwise aligned; they had similar missions, understood their differing approaches to care, and administrators demonstrated an openness and support for the collaboration.

2) Hospices developed infrastructures to correspond to the uniqueness and complexity of the nursing home environment. For example, they hired nurses with nursing home backgrounds, created teams dedicated to nursing home care, and trained hospice staff in problem solving and conflict resolution.

3) Care collaboration processes focused on the importance of two-way communication by actively soliciting and sharing information with nursing home staff and responding to nursing home staff and administrators' concerns.

This successful partnership model demonstrates how well collaboration can work when hospices and nursing home leaders commit to operating strategically using communication, flexibility, and skills to match staffing to the nursing home environment. 

Frances Shani Parker, Author


  1. I am a mother who is currently at home as a caregiver to my son. He is in palliative care with liver failure. Just this week we had a drama caused by the community care network which oversees the nurses and personal care workers who come into our home to assist with my son and relieve me for 2 hours per day. He had heard me talking about the care being taken away, as he had not expired within the six month limit. His reaction.... to talk about suicide because he thought he was being a burden on his family. I wonder of the elderly who commit suicide, how many of them think the same way.

  2. Linda, the post before this one deals with suicide of older adults. Suicide thoughts are not uncommon among those who are depressed and in your son's circumstances. If your son is talking about suicide, a very strong warning sign, he should be getting immediate help from trained professionals.

    You said he is receiving palliative care and "had not expired within the six month limit." The six month prediction implies that he is in hospice care ( a form of palliative care). I have had hospice patients who lived way beyond six months. The important thing is that he maintain high quality in his life.

    You have access to a social worker, chaplain, and others who can assist you with problems diminishing his quality of life. They are part of the hospice team available to support both of you. Alert them to your concerns immediately and get the help you both need. I wish you both the best.