Description
- Abstract:
- Key Message: In this mixed-methods study, bereaved next-of-kin report key motivations to enrolling in hospice, including meeting dying assisted living residents’ higher care needs and preference for dying in place. Hospice enrollment shapes the ability to die in place, even among assisted living communities with policies to retain residents at end-of-life or those that have registered nurse staffing. I. Introduction: This study explores narratives of bereaved next-of-kin of deceased residents from a diverse sample of assisted living (AL) communities. Narratives are stratified by retention policy at end-of-life (EoL) and registered nurse (RN) staffing, focusing on AL care quality and hospice utilization. II. Methods: We conducted 52 semi-structured telephone interviews with bereaved next-of-kin of persons who resided in AL during the last month of life, purposefully oversampling racially and ethnically diverse ALs. Two coders performed content analysis for the first 30 interviews. We compared qualitative data according to AL care processes obtained through a nationally representative survey of administrators. For analysis, we used survey data regarding the policy to retain residents at EoL (vs. case-by-case vs. discharge) and RN availability. Exploratory thematic analysis was applied to compare narratives addressing AL end-of-life care quality (e.g., next-of-kin perceptions of dying residents’ needs being met as a factor of RN availability reported by administrators). III. Results: Nearly all decedents (96.2%) in the qualitative sample resided in AL communities with policies to retain dying residents or evaluate them case-by-case. The two decedents in our sample at AL communities with a discharge policy were transferred before death. Next-of-kin cited the desire for more staff attention and avoiding late-life transitions as key motivating factors for enrolling in hospice. Even in AL communities with policies to retain dying residents, next-of-kin reported receiving an ultimatum to either enroll them in hospice or move them to another setting like a nursing home. Regardless of RN availability, next-of-kin elected hospice to enhance staff access, particularly overnight presence and support for residents at risk of falling. IV. Conclusion Our study highlights hospice care’s importance in allowing residents to die in place across AL communities with varying policies regarding end-of-life care and RN availability.
- Notes:
- Scholarly concentration: Non-Scholarly Concentrator
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Citation
Dagen, Nicole, Weems, Jacy, Gadbois, Emily, et al.,
"Bereaved Next-of-Kin Narratives about Hospice Care in Assisted Living"
(2024).
Warren Alpert Medical School Academic Symposium.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:qqprgwq3/
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Warren Alpert Medical School Academic Symposium
The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …...