Staff views about healthcare play major roles in what they do, why they do it, and how they affect others. Nursing home staff perspectives regarding hospice care are particularly
important because lives are literally at stake. As a hospice volunteer for many
years in nursing homes, I was very aware of this relationship and the powerful
impact of attitudes on resident care. More research in this area is both welcome and
needed.
This research on nursing home staff hospice perspectives included views of 1,229 certified nursing assistants (CNAs),
nurses, and social workers toward hospice care in 52 Indiana nursing homes.
They responded to questions and open-ended prompts with these results:
1) A majority of staff
responded favorably regarding hospice care in nursing homes.
2) About one-third of nursing
home staff rated coordination of care lower than other aspects. Many comments
highlighted examples of hospice being non-responsive to residents' needs. These
represented important opportunities for improvement.
Based on my own readings and experiences as a
hospice volunteer and former school administrator, three ways for improving
hospice in nursing homes include more staff education, implementation, and
monitoring of hospice practices. This must be ongoing, particularly in nursing
homes with high staff turnover.
Nursing home staff members who are focused on
curing hospice residents may not readily embrace the hospice philosophy of non-curative care. For some, this is a major paradigm shift in thinking. It is critical that they commit to enhancing and maintaining their expertise in
hospice practices. This includes the referral or non-referral of residents to
hospice care and the timing of those referrals.
The quality of end-of-life care for any patients
depends on the context in which the care is given. In the context of a nursing
home, views of staff members regarding the hospice philosophy and the
implementation of that philosophy greatly impact hospice residents’ experiences.
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.
Read about who leaves
hospice alive. Discharges can occur for several reasons:
https://www.linkedin.com/pulse/leaving-hospice-alive-research-nursing-home-story-parker?trk=mp-reader-card
Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer
in Urban Nursing Homes is available in paperback and e-book
editions in America and other countries at online and offline booksellers.
