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Medline ® Abstracts for References 7,8

of 'Palliative care delivery in the home'

7
TI
Innovative models of home-based palliative care.
AU
Labson MC, Sacco MM, Weissman DE, Gornet B, Stuart B
SO
Cleve Clin J Med. 2013 Jan;80 Electronic Suppl 1:eS30-5.
 
The focus of palliative care is to alleviate pain and suffering for patients, potentially while they concurrently pursue life-prolonging or curative therapy. The potential breadth of palliative care is recognized by the Medicare program, but the Medicare hospice benefit is narrowly defined and limited to care that is focused on comfort and not on cure. Any organization or setting that has been accredited or certified to provide health care may provide palliative care. Home health agencies are highly attuned to patients' need for palliative care, and often provide palliative care for patients who are ineligible for hospice or have chosen not to enroll in it. Two home health-based programs have reported improved patient satisfaction, better utilization of services, and significant cost savings with palliative care. Moving the focus of care from the hospital to the home and community can be achieved with integrated care and can be facilitated by changes in government policy.
AD
Home Care Program, The Joint Commission, One Renaissance Blvd, Oak Brook Terrace, IL 60181, USA. MLabson@jointcommission.org
PMID
8
TI
Palliative Access Through Care at Home: experiences with an urban, geriatric home palliative care program.
AU
Holley AP, Gorawara-Bhat R, Dale W, Hemmerich J, Cox-Hayley D
SO
J Am Geriatr Soc. 2009 Oct;57(10):1925-31. Epub 2009 Aug 21.
 
The aging of the U.S. population has resulted in a large number of persons with multiple, chronic illnesses and gradual functional decline. Many older adults with these conditions are homebound and have great difficulty accessing medical care. They are also more likely to suffer from unaddressed symptoms and end-of-life care needs. Certain groups, such as African-American patients and patients with dementia, are even less likely to access palliative care and hospice services. Although the informal caregivers attending to such persons may become overwhelmed without adequate support, palliative care, which covers a broad population, is an optimal way to address many of these needs. This article describes a unique, urban, home-based geriatrics palliative care program (Palliative Access Through Care at Home (PATCH)) designed to address some of these unmet needs. After 1 year of providing service, a mixed-methods study consisting of chart review, telephone interviews, and face-to-face interviews was conducted to assess caregiver expectations of and satisfaction with the program. Caregivers for the elderly, mostly African-American patients, more than half of whom had dementia, were overall very satisfied with their experience, despite the large amount of time necessary to provide the care that patients required. Themes extracted during qualitative analysis were the desire to remain at home, the need for easy access to a practitioner specializing in geriatrics and palliative medicine, and the challenges of transitions of care. PATCH was able to address many of these needs and provide high levels of caregiver satisfaction.
AD
Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, Illinois, USA. Abigail.Holley@uchospitals.edu
PMID