Retrospective Analysis of a Home Care Hospice Program

1985 ◽  
Vol 15 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Frank J. Brescia ◽  
Matthew Sadof ◽  
Janice Barstow
Keyword(s):  
Palliative Care ◽  
Retrospective Study ◽  
Home Care ◽  
Patient Population ◽  
Hospital Setting ◽  
Care Program ◽  
Patient Status ◽  
Symptom Complex ◽  
Specific Symptoms ◽  
At Home

This is a retrospective study of patients who died in the Overlook Hospice Home Care Program during a six-month period. Parameters to define and document quality palliative care were measured and differences between the patient population who died at home and those who died in the hospital setting were also recorded. Among the patients who died at home, there was no symptom complex which was perceived as unmanageable by the patient's family, nurse, or physician. We could not predict which patients would be able to die at home in this study. In the future, more complete documentation of patient status, specific symptoms, and whether these symptoms are relieved will be necessary.

scholarly journals P2-509: INITIAL FINDINGS FROM A TECHNOLOGY-ENABLED DEMENTIA CARE PROGRAM IN A POLYCHRONIC PATIENT POPULATION LIVING AT HOME

2019 ◽  
Vol 15 ◽  
pp. P812-P813
Author(s):  
Kevin Liang ◽  
Dirk Soenksen ◽  
Sabita Lahiri ◽  
Christopher Dennis
Keyword(s):  
Patient Population ◽  
Care Program ◽  
Dementia Care ◽  
At Home

A Specialized Home Care Team Does Make a Difference

1992 ◽  
Vol 5 (3) ◽  
pp. 38-41
Author(s):  
Dorothy Larson ◽  
Ralph Odegard ◽  
N.E. Brown
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care System ◽  
Care Program ◽  
Care Team ◽  
Research Facility ◽  
Teaching And Research ◽  
The Cost ◽  
Care System ◽  
At Home

Results of a study done in a large teaching and research facility in Alberta reveal that a specialized home care team can substantially lower the cost of caring for people who are ventilator dependent. With the assistance of a pulmonary physician, the Respiratory Home Care program has shown excellent results. Patients report that they “feel as safe at home as in the hospital”, and the savings to the health care system are estimated to be about $2,000,000 per year.

Scarborough's Palliative ‘At-Home’ Care Team (PACT): A Model for a Suburban Physician Palliative Care Team

1995 ◽  
Vol 11 (3) ◽  
pp. 43-49 ◽  
Author(s):  
J.S. Gardner-Nix ◽  
R. Brodie ◽  
E. Tjan ◽  
M. Wilton ◽  
L. Zoberman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Palliative Care Team ◽  
Care Team ◽  
At Home

Provision of specialized palliative care in a multiprofessional network.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 144-144
Author(s):  
Jens Hermann Papke
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Outpatient Setting ◽  
Multiprofessional Team ◽  
Nursing Services ◽  
Palliative Care Teams ◽  
Specialized Palliative Care ◽  
Dying At Home ◽  
Karnofsky Index ◽  
At Home

144 Background: In Germany specialised palliative care in outpatient setting is financed by health insurances since 2007. Home Care Sachsen e.V. is a specialised palliative care provider working with two palliative care teams including qualified nurses, physicians and social workers in closely cooperation with general practitioners and nursing services. We report about the results of our work in a rural area around Dresden in Saxony, Germany. Methods: Our data were collected prospectively with PalliDoc software. Results: Between 2011 – 2013 Home Care Sachsen e.V. served for 1,572 pts (888 m, 684 f); 93% with an oncologic disease. Median age was 71 y, Karnofsky index was 40%, median caring time 27 days. In this time, 25% of our pts had one stay in hospital, 8% two and 4% three and more. 63% had no stays in hospital. At least 1,271 pts. died: 65% at home; 9% in nursing homes and hospices; 15% in palliative care units and 11% in hospital. Conclusions: Mean home death rate of oncologic pts without intervention in Germany is about 44% (Papke J, Koch R: Places of Death from Cancer in a Rural Location. Onkologie (2007) 30, 105-08). This proportion could be enhanced considerably with outpatient palliative care. Providing of specialised palliative care with a multiprofessional team is effective to increase the rate of dying at home and to fulfill one of the strongest wishes of pts in a palliative situation.

Use of Complementary Therapies in Hospice and Palliative Care

2013 ◽  
Vol 67 (1-2) ◽  
pp. 227-232 ◽  
Author(s):  
Alison Vandergrift
Keyword(s):  
Palliative Care ◽  
Complementary Therapies ◽  
Care Program ◽  
Pain Reduction ◽  
Anxiety Reduction ◽  
Medical Community ◽  
Palliative Care Program ◽  
Hospice And Palliative Care ◽  
Specific Symptoms

As society has become increasingly inquisitive about complementary therapies, various sectors of the medical community have begun to incorporate complementary therapies into their practice, studying their impact on client health and effectiveness in treating specific symptoms. This article describes the design and initial findings from a 1-year review of the implementation of massage and Reiki therapies on patients in a small hospice and palliative care program in central Connecticut. Over the course of 1 year, 114 massage sessions were provided to 52 different patients, all of which included Reiki. After completion of these sessions, patients were evaluated for changes in symptoms such as pain reduction, ease in breathing, stress/anxiety reduction, and increased relaxation, with the results being predominantly beneficial.

scholarly journals Gastrointestinal Symptoms in Children With Life-Limiting Conditions Receiving Palliative Home Care

2021 ◽  
Vol 9 ◽  
Author(s):  
Holger Hauch ◽  
Peter Kriwy ◽  
Andreas Hahn ◽  
Reinhard Dettmeyer ◽  
Klaus-Peter Zimmer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Phase 1 ◽  
Gastrointestinal Symptoms ◽  
Phase 2 ◽  
Palliative Home Care ◽  
Asymptomatic Children ◽  
Number Of Patients ◽  
Gi Symptoms ◽  
At Home

Context: Children with life-limiting diseases suffer from gastrointestinal (GI) symptoms. Since the introduction of specialized palliative home care (SPHC) in Germany, it is possible to care for these children at home. In phase 1 of care the aim is to stabilize the patient. In phase 2, terminal support is provided.Objectives: Analysis were performed of the differences between these phases. The causes and modalities/outcome of treatment were evaluated.Methods: A retrospective study was performed from 2014 to 2020. All home visits were analyzed with regard to the abovementioned symptoms, their causes, treatment and results.Results: In total, 149 children were included (45.9% female, mean age 8.17 ± 7.67 years), and 126 patients were evaluated. GI symptoms were common in both phases. Vomiting was more common in phase 2 (59.3 vs. 27.1%; p < 0.001). After therapy, the proportion of asymptomatic children in phase 1 increased from 40.1 to 75.7%; (p < 0.001). Constipation was present in 52.3% (phase 1) and 54.1% (phase 2). After treatment, the proportion of asymptomatic patients increased from 47.3 to 75.7% in phase 1 (p < 0.001), and grade 3 constipation was reduced from 33.9 to 15% in phase 2 (p < 0.05).Conclusion: Painful GI symptoms occur in both palliative care phases but are more common in phase 2. The severity and frequency can usually be controlled at home. The study limitations were the retrospective design and small number of patients, but the study had a representative population, good data quality and a unique perspective on the reality of outpatient pediatric palliative care in Germany.

An innovative model for palliative care at home for 100,000 patients with cancer since 1985 in Italy: A social partnership for a public health system integrated and sustainable.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 113-113
Author(s):  
Raffaella Pannuti ◽  
Silvia Varani ◽  
Franco Pannuti
Keyword(s):  
Public Health ◽  
Palliative Care ◽  
Health Service ◽  
Home Care ◽  
Public Health Service ◽  
Social Institutions ◽  
National Average ◽  
The Public ◽  
Italian Regions ◽  
At Home

113 Background: In Italy, like in most Western countries, the number of elderly people with a chronic disease is constantly increasing and it causes a growth in disability and frailty. However, the Public Health Service is unable to provide all the services needed. Therefore it is necessary to find urgent actions to fill in the gaps of the Public Health Service and to think about appropriate solutions for a sustainable future. Methods: Since 1985, ANT has assisted at home more than 100,000 cancer sufferers, completely free of charge, thanks to its 20 oncological teams in 9 Italian regions. There are currently about 4,000 patients receiving care every day throughout Italy. ANT offers specialized care provided by 400 healthcare professionals, including doctors, nurses, psychologists, nutritionists, physiotherapists, social-health workers, who are able to provide patients with round the clock care, 365 days a year. Results: The quality of the model of ANT home care is supported by the following outcomes: 78% of the patients (ANT National average) choose to die at their own home in contrast with the National average of cancer death at home equal to 57,9%. In the last 30 days of life, 74% of the patients assisted by ANT aren’t admitted to hospital, 12% have an hospitalization lasting less than 7 days and only 14% remain in hospital for over a week. The customer satisfaction, assessed through a questionnaire sent to families about a month after death, shows that 90% of respondents are very satisfied with the assistance received. ANT spends about 2,090 euro for each patient assisted. Given that each patient is cared for an average of 132 days, the cost is about 30 euro a day. This charge is much lower than a recovery for a day in a palliative care residential facility (240 euro) and it is lower also than an admission for a day in a public hospital (780 euro). Conclusions: The situation calls for a change in strategies in health policy, stimulating integration between public and social institutions. The model of ANT home care is an example of a social buffer that offers an integrated health and social assistance able to meet the increasingly complex needs of patients and their families.

Is it possible for caregivers to administer subcutaneous hydration to patients with advanced cancer at home? Feasibility and perceptions.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 82-82
Author(s):  
Monica Grez ◽  
Pedro Perez-Cruz ◽  
Alfredo Rodriguez-Nunez ◽  
Francisca Villouta ◽  
Carolina Jaña ◽  
...  
Keyword(s):  
Palliative Care ◽  
Multivariate Analysis ◽  
Advanced Cancer ◽  
Prior Experience ◽  
Primary Caregivers ◽  
Care Program ◽  
Oral Route ◽  
Palliative Care Program ◽  
A Prospective Study ◽  
At Home

82 Background: Loss of oral route is common in patients with advanced cancer, particularly during end-of-life (EOL). EOL hydration may prevent the onset of symptoms associated with dehydration, mainly delirium, or decrease the severity of symptoms when they are present. Subcutaneous hydration (SCH) is the best way to hydrate the patients at home although it is infrequently used. Objectives: To evaluate the feasibility of receiving SCH at home administered by caregivers without previous experience and their subsequent perceptions. Methods: A prospective study of 52 patients with advanced cancer enrolled in a Home Palliative Care Program and their primary caregivers. Caregivers of patients were trained in SCH administration at home. Telephone controls were performed at 48 hours and at 7 days to assess adherence and complications. One month after the death, a survey to explore caregiver perceptions of SCH was performed. Results: Fifty-two patients were included, the median days with SCH were 12 (2-173) and 100% were able to maintain SCH for all the time indicated or until the patient died. The proportion of caregivers who reported that administering SCH had been easy or very easy were 35 (78%) and 26 (96%) at 48 hrs and at seven days, respectively. In the multivariate analysis, caregiver demographics were not associated with finding administration of SCH easy (Table 1). Adverse effects were mild and infrequent. Four weeks after the death, 98% (95% CI 0.88-0.99) of the caregivers reported that it was useful to have administered SCH to their relative.Conclusions: It is feasible to administer SCH to patients who are at home, by caregivers with no prior experience. Implement this technique at home will allow us to decrease the percentage of patients with dehydration at the EOL and to decrease the complications of being dehydrated. [Table: see text]

Supportive care day hospital: A new tool for palliative care in cancer centers.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 170-170
Author(s):  
Carole Bouleuc
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Supportive Care ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Plan ◽  
Day Hospital ◽  
Cancer Centers ◽  
Advance Care ◽  
At Home

170 Background: In May 2005, the Curie Institute in Paris opened the first supportive care day hospital in France. This type of new ward is now very frequent in the French comprehensive cancer centers. Methods: Patients are managed by the palliative care team with a two-part team of a physician and a nurse in order to address their supportive care needs: advanced-care symptoms, psychosocial distress, medical questions and concerns, support need in decision making, end of life care preference and advance care plan when patients or caregivers when needed. Depending of the needs identified by the palliative care team assess, at least 2 of the following healthcare professionals will intervene: oncologist, pain physician, psycho-oncologist, dietitician, social worker, physiotherapist. Coordination with the home care team takes systematically place (with general practitioner, nurse and home palliative care team). New symptoms occurrence are explored with biological test or radiographic examination when necessary. Medical procedures are sometimes performed like venous perfusion therapy, blood transfusions, or draining effusion after ultrasonic tracking. It is possible to offer the patient hypnosis, relaxation or sophrology consultation. Eventually at the end of the in-patient stay, the patient is given a medical synthesis with therapeutic recommendations and personalized care plan. 1 Physician and two nurses are needed to manage 4 patients every day. Results: In 2016 we have admitted 350 patients and performed 948 stays in our supportive rand 55% of them have breast cancer. Median survival since the first day at supportive care day hospital is 65 days. Death at home occurred in 15% of patients and in hospice for 62%. Home death is more often when patients don’t have any dyspnea are included in a home palliative care network and when they receive the last chemotherapy more than 30 days before death. More date will be shown. Conclusions: Supportive care day hospital is really a good tool for integrated palliative care, promoting collaboration with oncologists, coordination with home care teams, and advance care planning, so that patients can longer stay at home as they often hope so.

A Comparison Study of Parental Adaptation Following a Child's Death at Home or in the Hospital

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Mary E. Lauer ◽  
Raymond K. Mulhern ◽  
Joyce M. Wallskog ◽  
Bruce M. Camitta
Keyword(s):  
Home Care ◽  
Care Program ◽  
Care Experience ◽  
Life And Death ◽  
Parental Adaptation ◽  
Dying Children ◽  
One Year ◽  
Child's Death ◽  
Voluntary Choice ◽  
At Home

Mothers and fathers of 37 deceased pediatric oncology patients were interviewed 3 to 28 months after their child's death. Twenty-four of these families had participated in a formal Home Care Program for dying children, whereas the remaining 13 families had children who died in the hospital. Parental adaptation following the home care experience appeared to be more favorable than following terminal care and death in the hospital. Specifically, the parents who had cared for their terminally ill child at home displayed more positive adjustment patterns as indexed by their perception of how the child's death had affected their marriage, social reorientation, religious beliefs, and views on the meaning of life and death. Ratings given by parents providing home care indicated a significant reduction in guilt during the home care experience which was maintained at 6 and 12 months following the child's death. In contrast, parents who did not provide home care reported intensified feelings of guilt during their child's terminal hospitalization which were unresolved at one year after the child's death. The results are discussed in terms of the practical and emotional benefits that may be derived from a family's voluntary choice of home care for dying children.

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