RAND Research Topic: Palliative Care 2021-04-06T13:57:16Z Copyright (c) 2021, The RAND Corporation RAND Corporation https://www.rand.org/topics/palliative-care.html Bereaved Family More Likely to Report "Too Little" Care Than "Too Much" Care at the End of Life Joan M. Teno; Jennifer N. Bunker; Melissa A. Bradley; Julia Bandini; Christine Ritchie; Danielle Schlang; Hyosin Kim; Rebecca Anhang Price https://www.rand.org/pubs/external_publications/EP68589.html 2021-03-31T10:45:00Z 2021-03-31T10:45:00Z Interviews with family members about their loved one's end-of-life care found that a majority thought he or she received the right amount of care. One in six said their family member received too little care. Racial Differences in End-of-Life Care Quality Between Asian Americans and Non-Hispanic Whites in San Francisco Bay Area Hyosin Kim; Rebecca Anhang Price; Jennifer N. Bunker; Melissa A. Bradley; Danielle Schlang; Julia Bandini; Joan M. Teno https://www.rand.org/pubs/external_publications/EP68538.html 2021-03-02T08:30:00Z 2021-03-02T08:30:00Z Compared with caregivers of non-Hispanic whites, caregivers of Asian decedents reported unmet needs for caregiver support and lack of respect for cultural traditions and religious/spiritual beliefs. Hospice Care Experiences Among Cancer Patients and Their Caregivers Layla Parast; Anagha Alka Tolpadi; Joan M. Teno; Marc N. Elliott; Rebecca Anhang Price https://www.rand.org/pubs/external_publications/EP68537.html 2021-02-26T09:15:00Z 2021-02-26T09:15:00Z Opportunities exist to improve hospice care for symptom palliation and training for caregivers when their family members are at home or in an ALF setting. Efforts to improve care for cancer patients in the NH and ALF setting are especially needed. Negotiating the 'Buffet' of Choice Julia Bandini https://www.rand.org/pubs/external_publications/EP68263.html 2020-09-03T11:30:00Z 2020-09-03T11:30:00Z This article explores medical decision-making in the setting of the intensive care unit (ICU) drawing on ethnographic data of ICUs as well as interviews with family members of critically ill patients as and clinicians. Dyadic Model of Adaptation to Life-Limiting Illness Sangeeta C. Ahluwalia; Neha K. Reddy; Rebecca Emily Johnson; Linda L. Emanuel; Sara J. Knight https://www.rand.org/pubs/external_publications/EP68209.html 2020-06-26T10:00:00Z 2020-06-26T10:00:00Z This review of the scholarly and empirical literature as well as a growing body of research examining adjustment to the prospect of the end of life support the concept of dyads, where one member of a mutual partnership is experiencing losses in the context of life-threatening illness while the other member goes through adjustments. Differences in Caregiver Reports of the Quality of Hospice Care Across Settings Denise D. Quigley; Layla Parast; Ann C. Haas; Marc N. Elliott; Joan M. Teno; Rebecca Anhang Price https://www.rand.org/pubs/external_publications/EP68207.html 2020-06-25T11:45:00Z 2020-06-25T11:45:00Z Important opportunities exist to improve quality of hospice care in nursing homes and assisted-living facilities. Quality improvement and regulatory interventions targeting these settings are needed to ensure that all hospice decedents and their family receive high-quality, patient- and family-centered hospice care. Characteristics of Hospices Providing High-Quality Care Rebecca Anhang Price; Anagha Alka Tolpadi; Danielle Schlang; Melissa A. Bradley; Layla Parast; Joan M. Teno; Marc N. Elliott https://www.rand.org/pubs/external_publications/EP68205.html 2020-06-25T10:00:00Z 2020-06-25T10:00:00Z Hospice characteristics associated with strong performance on Hospice Item Set measures differ from those associated with strong performance on CAHPS measures. Providing professional staff visits in the last two days of life is associated with high performance in both quality domains. Palliative Care and Infection Management at End of Life in Nursing Homes Aluem Tark; Leah V. Estrada; Mary E. Tresgallo; Denise D. Quigley; Patricia Stone; Mansi Agarwal https://www.rand.org/pubs/external_publications/EP68113.html 2020-03-19T09:00:00Z 2020-03-19T09:00:00Z The aim of this study was to describe the current status of how nursing homes integrates palliative care and infection management at end of life across the nation. Health System and Beneficiary Costs Associated With Intensive End-of-Life Medical Services Risha Gidwani; Steven M. Asch; Vincent Mor; Todd H. Wagner; Katherine Faricy-Anderson; Samantha Illarmo; Gary Hsin; Manali L. Patel; Kavitha Ramchandran; Karl Lorenz; Jack Needleman https://www.rand.org/pubs/external_publications/EP68109.html 2020-03-11T09:45:00Z 2020-03-11T09:45:00Z The objective of this paper is to quantify expected beneficiary and health system costs incurred in association with receipt of intensive medical services in the last month of life. Development of Palliative Care Quality Measures for Outpatients in a Clinic-Based Setting Emily K. Chen; Sangeeta C. Ahluwalia; Kanaka Shetty; Francesca Pillemer; Jason Michel Etchegaray; Anne Walling; Alice Y. Kim; Monique Martineau; Jessica Phillips; Carrie M. Farmer; Katherine Ast https://www.rand.org/pubs/research_reports/RR4273.html 2020-02-25T08:30:00Z 2020-02-25T08:30:00Z This report summarizes information gathering activities completed as of September 2019. It provides background information on the importance of and need for development of quality measures for palliative care based on patient-reported experience. Effecting Change, Improving Health RAND Corporation https://www.rand.org/pubs/corporate_pubs/CP943.html 2020-02-07T08:30:00Z 2020-02-07T08:30:00Z The RAND Corporation is dedicated to transforming the wellbeing of all people by improving health care systems in the United States and abroad. A Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition Sangeeta C. Ahluwalia; Christine Chen; Laura Raaen; Aneesa Motala; Anne Walling; Margaret Chamberlin; Claire E. O'Hanlon; Jody Larkin; Karl Lorenz; Goke Akinniranye; Susanne Hempel https://www.rand.org/pubs/external_publications/EP67819.html 2019-03-26T12:00:00Z 2019-03-26T12:00:00Z A substantial body of evidence exists to support clinical practice guidelines for quality palliative care but the quality of evidence is limited. Growing Evidence Supports Best Practices in Palliative Care RAND Corporation https://www.rand.org/news/press/2018/10/31/index1.html 2018-10-31T14:55:00Z 2018-10-31T14:55:00Z A rapidly aging U.S. population with complex care needs will likely accelerate emphasis on palliative care services. A review of palliative care research found substantial evidence to support clinical practice guidelines and was incorporated into the new edition of the guidelines. Changing Structures and Processes to Support Family Caregivers of Seriously Ill Patients Richard Schulz; Scott Beach; Esther M. Friedman; Grant R. Martsolf; Juleen Rodakowski; A. Everette James https://www.rand.org/pubs/external_publications/EP67416.html 2017-12-15T12:00:00Z 2017-12-15T12:00:00Z Fundamental changes are needed in the way we identify, assess, and support family caregivers of seriously ill relatives. Black and Hispanic Patients Receive Hospice Care Similar to That of White Patients When in the Same Hospices Rebecca Anhang Price; Layla Parast; Ann C. Haas; Joan M. Teno; Marc N. Elliott https://www.rand.org/pubs/external_publications/EP67246.html 2017-08-01T13:30:00Z 2017-08-01T13:30:00Z Black and Hispanic patients received care from poorer quality hospices than white patients. Black and Hispanic Patients More Likely to Use Lower-Quality Hospices Rebecca Anhang Price; Joan M. Teno https://www.rand.org/pubs/external_publications/EP67226.html 2017-07-05T16:00:00Z 2017-07-05T16:00:00Z Black and Hispanic patients are more likely to receive care from poorer-quality hospices. And their family caregivers are less likely to receive the right amount of emotional and religious support in hospice care. However, caregivers of black and Hispanic patients report similar or better experiences than caregivers of white patients within a given hospice. Development and Feasibility of a Structured Goals of Care Communication Guide David B. Bekelman; Sangeeta C. Ahluwalia; Anne Walling; Rebecca Sudore https://www.rand.org/pubs/external_publications/EP67158.html 2017-05-30T12:45:00Z 2017-05-30T12:45:00Z Studies demonstrate the benefits of discussing goals of care and advance care planning, yet many patients with serious illness do not engage in such discussions with healthcare providers. Populations and Interventions for Palliative and End-of-Life Care Adam E. Singer; Joy R. Goebel; Yan S. Kim; Sydney Dy; Sangeeta C. Ahluwalia; Megan Clifford; Elizabeth Dzeng; Claire E. O'Hanlon; Aneesa Motala; Anne Walling; Jaime Goldberg; Daniella Meeker; Claudia Ochotorena; Roberta M. Shanman; Mike Cui; Karl Lorenz https://www.rand.org/pubs/external_publications/EP66611.html 2016-09-12T13:00:00Z 2016-09-12T13:00:00Z This evidence review found that palliative care improves outcomes for cancer, dementia, congestive heart failure, and chronic obstructive pulmonary disease. Factors Associated with Family Reports of Pain, Dyspnea, and Depression in the Last Year of Life Adam E. Singer; Daniella Meeker; Joan M. Teno; Joanne Lynn; June R. Lunney; Karl Lorenz https://www.rand.org/pubs/external_publications/EP66583.html 2016-08-23T16:30:00Z 2016-08-23T16:30:00Z Family reports of patients' experiences with pain, difficult breathing, and depression near the end of life suggest strategies at the clinical and population level for assessing and managing symptoms. The Lack of Documentation of Preferences in a Cohort of Adults Who Died After Ischemic Stroke Maisha T. Robinson; Barbara Vickrey; Robert G. Holloway; Kelly Chong; Linda S. Williams; Robert H. Brook; Mei Leng; Punam Parikh; David Zingmond https://www.rand.org/pubs/external_publications/EP66441.html 2016-04-22T10:15:00Z 2016-04-22T10:15:00Z Stroke patients' wishes to limit life-sustaining interventions were documented in less than 40 percent of cases in which patients died 30 days after hospital admission.