The nursing home culture change movement aims to improve resident quality of life and quality of care by emphasizing the deinstitutionalization of nursing home culture and focusing on person-centered care.
Research based primarily on reports from an individual's surviving relatives often suggests that end-of-life care experiences are particularly poor. However, this examination of reports from patients found that those who died within a year of being surveyed reported slightly better experiences than other enrollees.
There is a growing emphasis on promoting medical treatments that provide the most benefits relative to their costs.
Estimation of six-month prognosis is essential in hospice referral decisions, but accurate, evidence-based tools to assist in this task are lacking.
Cancer Quality-ASSIST indicators are useful for practical quality assessment of cancer end-of-life care in an academic medical center.
Evaluation of implementation of a standardized order set can identify areas for quality improvement and missed opportunities for use.
Communication is an ongoing challenge for clinicians working with people facing life-threatening illnesses and end of life. Family conferences offer patient-focused, family-oriented care that brings together patients, family members, and health care providers.
Longitudinal studies examining care for seriously ill patients are needed to understand patients' experience of illness, evaluate interventions, and improve quality of care. Unfortunately, such studies face substantial methodological challenges. This article describes such challenges and the strategies used to overcome them in a successfully implemented palliative care intervention trial for veterans.
High Medicare spending is not associated with better health outcomes at a regional level, but patients admitted to California hospitals from 1999 to 2008 had lower inpatient mortality in those hospitals that spent more on end of life care.
The authors estimated at pounds 1.8 billion the cost to the taxpayer of care for the 127,000 patients dying from cancer in 2006. The equivalent cost for the 30,000 people dying from organ failure was pounds 553 million. Resources of pounds 16 to pounds 171 million could be released for cancer.
Patients admitted to a teaching hospital for an end-of-life illness generally receive high-quality medical care, but there is a need for better communication about family expectations and for timely efforts to keep patients comfortable.
This study assessed hospice use by men dying of prostate cancer and compared the use of high-intensity care between those who did or did not enroll in hospice. Those who enroll in hospice are less likely to receive high-intensity end-of-life care.
Most physicians report they would not discuss end-of-life options with terminally ill patients who are feeling well, instead waiting for symptoms or until there are no more treatments to offer.
Discussing hospice with a health care provider could increase awareness of hospice and possibly result in earlier use.
Using data for 1996 to 2004 from the United States Health and Retirement Study, this article examines the differences between parents and childless older people in financial transfers to people other than their children.
Hospice care has been found to improve symptom management, quality of death and quality of life at the end of life.
The purpose of this article is to examine variation in resource utilization across and within patient stays in the context of Medicare's per diem payment system for hospice.
In the United States and abroad, the aging of the population and changes in its demographic and social composition raise important considerations for the future of health care and the systems that pay for care.
The authors examined whether the effect of parental death on adults siblings' relationship quality varies on the basis of the presence and perceived effectiveness of a deceased parent's formal preparations for end-of-life care.
Evaluates factors that affect the financial performance of hospice.