Abstract
Objectives
Older adults in need of residential services are increasingly spending their final
days in small, domestic-style care settings such as adult family homes. In this study,
we sought to identify processes that facilitated the provision of quality hospice
care to seriously ill residents of adult family homes and their family members.
Design
We conducted a secondary analysis of qualitative data collected as part of a randomized
clinical trial of a problem-solving intervention for family members of hospice patients.
Setting
The original trial was conducted in partnership with 2 large, community-based hospice
agencies in the state of Washington.
Participants
Data from 73 family members of residents of adult family homes receiving hospice services
were included in the analysis.
Measurements
Data were collected via semi-structured individual interviews, which were audio-recorded
and transcribed prior to analysis.
Results
Family members described quality hospice care in the adult family home as care that
is consistent with residents and families' values and that results in comfort and
social connectedness for residents while promoting peace of mind and decreasing burden
for residents' families. They identified numerous processes that facilitated the provision
of quality care including personalizing care, sharing information and expertise, working
together to resolve conflicts, and prioritizing residents and families' values over
existing or competing philosophies of care.
Conclusion
The adult family home setting can amplify both the benefits and challenges associated
with receipt of hospice. When choosing an adult family home, older adults and their
families should strongly consider selecting a home with a track record of positive
collaborations with hospice agencies if the need for end-of-life care is anticipated.
Keywords
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Article info
Publication history
Published online: September 30, 2017
Footnotes
The authors declare no conflicts of interest.
This study was funded by the National Institute on Nursing Research Grant R01NR012213 (Principal Investigator: Demiris). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the study's funder.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
