Factors of Good Collaboration in Home-Based End-of-Life Care: A Questionnaire Survey of Japanese Home Care Nurses, Home Helpers, and Care Managers

2015 ◽  
Vol 16 (3) ◽  
pp. 129-140 ◽  
Author(s):  
Noriko Yamamoto-Mitani ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Yukie Takemura ◽  
Miho Suzuki
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Collaborative Work ◽  
Care Managers ◽  
Actual Experience ◽  
Home Based ◽  
Eol Care ◽  
The Relationship ◽  
Home Helpers ◽  
Home Care Nurses

Good interprofessional work (IPW) is essential to provide quality home-based end-of-life (EOL) care. The purpose of this study was to explore the factors of “good collaboration,” as evaluated separately by home care nurses (HNs), home helpers (HHs), and care managers (CMs). The relationship was examined between their evaluation of good collaboration and their recent actual experience of interprofessional collaborative work for a home-based EOL case. The questionnaire was returned nationwide by 378 HNs, 305 HHs, and 476 CMs, and data were collected on 177 EOL cases from HNs, 84 cases from HHs, and 123 cases from CMs. Evaluation of good collaboration by HNs was associated with working with a CM with whom they had multiple collaborative experiences, the client being independent for their toileting until just before dying, and sharing information regarding the client’s EOL decision with an HH 1 month before dying. Evaluation of good collaboration by HHs was associated with working at an agency that collaborated with fewer CM agencies and working at an agency that allowed staff to visit dying clients. Evaluation of good collaboration by CMs was associated only with the client being dependent for toileting. Our results highlighted the characteristics of how each professional seeks to collaborate depending on their preparedness, contexts, and resultant expectations toward other professionals when entering the IPW for home-based EOL care. To promote good IPW for home-based EOL care further, professionals need to understand these differences among ourselves and try to meet others’ expectations.

scholarly journals What Is Important at the End of Life? Perspectives From Experienced Home Care Workers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 70-70
Author(s):  
Emma Tsui ◽  
Emily Franzosa ◽  
Kathrin Boerner
Keyword(s):  
New York ◽  
Home Care ◽  
End Of Life ◽  
Limited Information ◽  
Care Providers ◽  
Patient Death ◽  
Home Based ◽  
Care Workers ◽  
Home Care Workers ◽  
Eol Care

Abstract Home care workers (HCWs) make up a large and rapidly growing sector of the American health care workforce serving older adults. This study focuses on a common but understudied feature of home care labor: workers’ thoughts around what makes a "good" or "bad" patient death. While researchers have investigated patients’, families’, physicians’, and other care providers’ perspectives on this issue, the perspectives of HCWs, who contribute substantially to home-based care at the end of life, have yet to be explored. We conducted 40 in-depth interviews with HCWs in New York City on their experiences with and reflections on patient death. We used a inductive, iterative approach to analyze data on what HCWs believe is important for dying patients. HCWs described EOL values that align well with the views held in common by patients, families, and other care providers, like the importance of not being alone when dying and being physically comfortable (not in pain and not suffering). In particular, HCWs conceptualized a detailed role for themselves when providing EOL care near the time of death. HCWs’ sustained presence and relationships with patients may uniquely position them to assist in the attainment of patients’ EOL goals, particularly when HCWs understand what these goals are. HCWs’ potential for playing this role, however, is jeopardized by a lack of training in EOL care and by the limited information they receive about a patient’s health status.

Home care nurses’ decisions about the need for and amount of service at the end of life

2010 ◽  
Vol 67 (2) ◽  
pp. 276-286 ◽  
Author(s):  
Kelli I. Stajduhar ◽  
Laura Funk ◽  
Della Roberts ◽  
Barbara McLeod ◽  
Denise Cloutier-Fisher ◽  
...  
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Home Care Nurses

Clergy religious beliefs and ICU utilization at the end of life.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 223-223
Author(s):  
Michael Balboni ◽  
Adam Sullivan ◽  
Rebecca Quinones ◽  
Tyler J. Vanderweele ◽  
Tracy A. Balboni
Keyword(s):  
End Of Life ◽  
Religious Beliefs ◽  
Religious Community ◽  
Medical Decisions ◽  
Divine Sovereignty ◽  
Sanctity Of Life ◽  
Aggressive Interventions ◽  
Relationship Of ◽  
Eol Care ◽  
The Relationship

223 Background: High religious community spiritual support is associated with greater aggressive interventions at the end of life (EOL). At EOL, half of U.S. patients are visited by clergy. The relationship of clergy religious beliefs about EOL care to dying congregants’ EOL medical decisions is unknown. Methods: This is an NCI-funded study of 1,665 U.S. clergy randomly-selected from a comprehensive database of 368,408 U.S. congregations and administered a survey 8/2014-2/2015; 1,005 responded (60%). Clergy reported endorsement of religious beliefs about congregants’ EOL care (RBEC), including miracles, sanctity of life, divine sovereignty, and redemptive suffering. Clergy reported on their last experience in spiritual caregiving to a dying congregant, including congregant’s care location in the final week. The primary outcome was any ICU care in the final week of life. Multivariable analyses (MVA), controlling for clergy age, gender, race, region, and congregational income, assessed the relationship of clergy RBEC to any congregant ICU care in the last week. Results: Most (86%) clergy affirmed belief in a miraculous cure; 54% agreed that the congregant should accept every medical treatment out of religious obligations. A minority of clergy affirmed that belief in divine sovereignty relieved congregants of future medical decisions (28%) and that they should endure medical procedures because suffering is God’s test (27%). In MVA, higher RBEC scores were associated with a greater likelihood of any ICU utilization in the last week (AOR=1.28, p=.02), with belief in divine sovereignty being the strongest predictor (AOR 2.1, p=.005). Predictors of having greater RBEC scores included being Hispanic (AOR=3.35, p<.001) or black (AOR=3.0, p<.001), as compared to white, and being Pentecostal (AOR=3.54, p<.001) or Evangelical (AOR=2.12, p<.001) as compared to clergy self-identified as liberal. Conclusions: A majority of clergy endorse religious beliefs regarding their dying congregants’ EOL medical care; these beliefs are associated with greater ICU care in the final days of life for congregants. Future research is needed to determine religiously-consistent approaches to clergy EOL education to mitigate aggressive interventions at the EOL.

Home Care Nurses’ Provision of Support to Families of the Elderly at the End of Life

2010 ◽  
Vol 21 (2) ◽  
pp. 199-213 ◽  
Author(s):  
Yuko Hirano ◽  
Noriko Yamamoto-Mitani ◽  
Mari Ueno ◽  
Shiho Takemori ◽  
Masayo Kashiwagi ◽  
...  
Keyword(s):  
Home Care ◽  
End Of Life ◽  
The Elderly ◽  
Home Care Nurses

The Life Experiences Among Primary Family Caregivers of Home-Based Palliative Care

2020 ◽  
Vol 37 (10) ◽  
pp. 816-822 ◽  
Author(s):  
Meng-Ping Wu ◽  
Sheng-Jean Huang ◽  
Lee-Ing Tsao
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
End Of Life ◽  
Family Caregivers ◽  
Family Members ◽  
Assessment Tools ◽  
Theory Approach ◽  
Home Based ◽  
Number Of Patients ◽  
Primary Family

Background: An increasing number of patients with terminal illnesses prefer to die in their own homes due to aging, high medical payments, a limited number of hospitalization days, and the ability to receive care from family members. However, few studies have been conducted on the subjective perception and value of caregivers for home-based palliative care (HBPC). Objective: To identify common themes and topics of primary family caregivers’ lived experiences with HBPC when taking care of terminally ill family members. Methods: We conducted audio-recorded transcripts of one-on-one in-depth interviews of primary family caregivers of HBPC. Through a purposive sampling method, the participants were all interviewed; these interviews were transcribed verbatim and analyzed using a grounded theory approach. Results: A total of 22 primary family caregivers participated in the study. “Wholeheartedly accompanying one’s family to the end of life at home” was the core category. Six main themes describing caregivers’ experiences emerged from the interviews: (1) learning the basic skills of end-of-life home care, (2) arranging the sharing and rotation of care, (3) preparing for upcoming deaths and funerals, (4) negotiating the cultural and ethical issues of end-of-life home care, (5) ensuring a comfortable life with basic life support, and (6) maintaining care characterized by concern, perseverance, and patience. Conclusions: Primary family caregivers of HBPC need support and must learn home care skills by means of the holistic approach. It is crucial to establish assessment tools for caregivers’ preparedness for HBPC, including biopsychosocial and cultural considerations.

End-of-Life Discussions and Aggressiveness of Care Received Near Death (DRAFT)

2018 ◽  
Author(s):  
Yael Schenker ◽  
Justin Yu
Keyword(s):  
Colorectal Cancer ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
End Of Life ◽  
Stage Iv ◽  
Intensive Care Unit Care ◽  
Cancer Stage ◽  
Eol Care ◽  
The Relationship ◽  
Advanced Cancer Stage

This chapter summarizes Mack and colleagues’ 2012 Associations Between End-of-Life (EOL) Discussion Characteristics and Care Received Near Death, which investigates the relationship between EOL discussion characteristics and the aggressiveness of EOL medical care received by patients with advanced cancer (stage IV lung or colorectal cancer). It reviews the frequency of which EOL discussions occur in this population and explores EOL discussion characteristics including timing, location, and involved providers. It then examines how these characteristics are associated with various markers of aggressive EOL care such as chemotherapy in last 14 days of life (DOL), acute or intensive care unit care in last 30 DOL, and initiation of hospice in last seven DOL.

Sign in / Sign up

Export Citation Format

Share Document