Enhancing Palliative Care for Low-Income Elders with Chronic Disease: Feasibility of a Hospice Consultation Model

Challenges exist in assimilating palliative care within community-based services for nursing home eligible low-income elders with complex chronic illness as they approach the end of life (EOL). This study assessed the feasibility of a consultation model, with hospice clinicians working with three Ca...

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Bibliographic Details
Published in:Journal of social work in end-of-life & palliative care 2014-01, Vol.10 (4), p.356-377
Main Authors: Kramer, Betty J., Cleary, James F., Mahoney, Jane E.
Format: Article
Language:English
Subjects:
Attitude to Death
chronic disease
Chronic Disease - therapy
Chronic Illness
Constraints
Cooperative Behavior
Elderly
feasibility study
Focus Groups
Hospice Care - organization & administration
hospice consultation
Hospices
Humans
Independent Living
Long-Term Care - organization & administration
Longitudinal Studies
Low Income Groups
Nursing Homes
Palliative Care
Palliative Care - organization & administration
Patient Care Team
Poverty
Social Integration
Social Work - organization & administration
Systems Integration
Wisconsin
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Summary:Challenges exist in assimilating palliative care within community-based services for nursing home eligible low-income elders with complex chronic illness as they approach the end of life (EOL). This study assessed the feasibility of a consultation model, with hospice clinicians working with three Care Wisconsin Partnership Program teams. Consults occurred primarily during team meetings and also informally and on joint patient visits and were primarily with the palliative care nurse addressing physical issues. Fifty-seven percent of consultant recommendations were implemented. Benefits of consultation were identified with focus groups of clinical staff as were opportunities and barriers to the implementation. Models of integration are proposed.
ISSN:1552-4256
1552-4264
DOI:10.1080/15524256.2014.975088