Having a loved one in hospice care can be a difficult thing for anyone to contend with. However, if you’re faced with the decision of where and how to have a loved one’s needs met with a hospice program, it is vital that you have all the information. In-home hospice care, nursing homes and assisted living facilities are all options that, when properly structured, can provide excellent care to hospice patients. Sifting through the myths about hospice care can be tiresome, but a new study casts some objective light on the differences between these mediums for hospice care. It is impossible to make sweeping statements based on the results of a single study however, these results are certainly worth considering while you plan how to ensure the greatest quality of life for your loved ones once they enter hospice care.
Background of the Hospice Study
The study in question was published in the Journal of the American Geriatrics Society, and was written by Dr. Kathleen T. Unroe, Brittany Bernard, Timothy E. Stump, Dr. Wanzhu Tu, and Dr. Christopher M. Callahan. The research was designed to look at a very large sample of patents by analyzing their medical hospital records. The research design allowed data from 32,605 patients to be analyzed, providing a very good sample size from which to draw observational conclusions.
Methods
Specifically, this study was looking at understanding how various service types were utilized, and how various providers interacted with their patients. The types of services being examined included things like how often a health professional visited a patient and how long that interaction lasted. Patients were excluded if their care received was more complex or involving or more elements than traditional hospice care.
One limitation in the study was a failure to carefully analyze in-depth the different circumstances of the patients and how this might affect their care, although descriptive statistics were provided on this front. Of interest is the fact that more than 50% of the patients receiving care at home were carrying a cancer diagnosis, while the patients who were in assisted living and nursing homes were comprised of roughly 33% dementia patients. The needs of dementia patients are much different than those of most cancer patients, something which would need to be looked at in further depth in follow up studies.
Study Results
When comparing the frequency of visits from health professionals, there were no meaningful differences between the three groups. Intuitively someone might assume that more frequent visits from health professional would be more likely in a facility. Publicly, many people worry that patients in facilities actually get seen less often than they should. The truth was that home care patients actually had the highest visitation rate, landing at 7.5 visits per week, while nursing homes and assisted living facilities came in at 7.4 and 7.3 visits per week respectively. The differences were so small that each group is receiving what amounts to the same amount of visits on a practical basis.
The differences between treatment options become more apparent when looking at what type of professionals were working with patients in the different environments. Visits with nursing aids were much more common in assisted living facilities, while people living at home had roughly one extra visit per week from an actual nurse. This also held true for the number of minutes the professionals were spending with patients each week. Nursing aides spent more time with those in assisted living facilities and nursing homes, and nurses spent more time with those living at home.
One finding was tied directly into the different kind of conditions faced by those living in nursing homes and assisted living facilities versus home patients. Those in nursing homes and assisted living facilities saw a specific pattern in the visits from nursing aides: specifically, there was less contact at the beginning and end of their stays, and more care in the middle. This is indicative of the pattern spoken of earlier, suggesting higher rates of dementia patients. For instance, after the patient is stabilized and settled into the new setting, nursing aides may be able to help them a great deal with daily living. Aid visits could decrease as other health professionals need to intervene more as the health of the patient declines
What Does This Mean to Me?
This study should come as a great comfort to people who are faced with the difficult task of finding the best hospice care solution for a loved one. In the past, many have expressed concerns that in certain care settings, patients receiving hospice care were receiving more or less attention from health professionals than those receiving care in an alternate setting.
What we have now seen with this study is that there is no overt differences in the amount of care someone receives, regardless of where they are receiving hospice care. Instead, the choice for the right placement may come down to questions revolving around quality of life. If a loved one is suffering from dementia where they simply can no longer be on their own, then a nursing home or an assisted living facility may be the best option. For those who can receive in home care though, and who would be happy doing so, that may also be a viable option.
Ultimately, this research confirms what providers of these services have known for some time. It is not about one service being “better” than another. Instead, it is more useful to think about these placements as finding the right fit between the care option and the patient in question.
How to Choose What is Right for Your Loved One
If they are still able to offer meaningful input, choosing hospice care with your loved is an emotional and difficult decision. We hope, however, this research brings some comfort to you. There is no “wrong” decision to make, where your loved one is going to receive substandard care. Whether you choose a nursing home, assisted living, or in-home hospice care, they are going to be receiving the same care and attention from health professionals. To find the right fit, it can sometimes be useful to speak with a professional with direct experience in all three options for hospice care. Contact Harbor Light Hospice to learn more about your options, and to discuss which scenario can offer the best quality of life to your loved ones.
