The Catholic University of America


Factors that Influence Interruption in Hospice Home Care

 

Dr. Danetta E. Hendricks

 

More than a decade has passed since researchers identified gaps in the literature exploring the causes of interruption in hospice care for eligible participants (Casarett, Marenberg, & Karlawish, 2001). Individuals admitted to hospice care have both a life threatening illness for which curative treatment is not available and knowledge that the expectation is that they will die from their disease in six months or less. Hospice programs support patients in maintaining their quality of life through the palliation of symptoms and supportive psychosocial and spiritual care.  Research on outcomes in hospice indicates that there are more positive outcomes in terminally ill patients who receive hospice care than those who do not receive specialized end of life care (Harper, 2011).  While reasons for leaving hospice alive may be positive in some aspects i.e., the disease is not progressing and a decline in health status is not present, other discharges may result in the inability to receive symptom control, leaving patients vulnerable to suffer through unmanaged end of life symptoms and die in pain. This retrospective, data analysis of hospice medical records seeks to identify factors that influence the interruption in hospice home care. A matched sampling technique using race and global diagnosis was employed to obtain a sample of 250 records.  The adapted behavioral model for vulnerable populations by Gelberg, Andersen, and Leake (2000) was used to guide the study.  Gelberg et al. suggest that variable within the domains of predisposing, enabling, and need can predict a health behavior outcome, the interruption in hospice home care versus no interruption. The variables used, age, gender, religion, spiritual distress, support system, client strengths, family caregiver, financial indicator, spiritual priority, pain score, distress score, and level of service, all fall within one of the three domains. Results of the logistic regression analysis indicate that significant predictors of interruption in hospice care include having a religious affiliation other than Baptist, other than Christian, and lacking a religious affiliation, financial situation, and level of service. These research findings support the use of the theoretical model and have implications for additional research and change in health policy.