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dc.creatorTeno, Joan M.en
dc.creatorClarridge, Brian R.en
dc.creatorCasey, Virginiaen
dc.creatorWelch, Lisa C.en
dc.creatorWetle, Terrieen
dc.creatorShield, Reneeen
dc.creatorMor, Vincenten
dc.date.accessioned2016-01-09T00:04:18Zen
dc.date.available2016-01-09T00:04:18Zen
dc.date.created2004-01-08en
dc.date.issued2004-01-08en
dc.identifierdoi:10.1001/jama.291.1.88en
dc.identifier.bibliographicCitationJAMA: The Journal of the American Medical Association 2004 January 7; 291(1): 88-93en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Family+perspectives+on+end-of-life+care+at+the+last+place+of+care&title=JAMA:+The+Journal+of+the+American+Medical+Association+&volume=291&issue=1&spage=88-93&date=2004-01&au=Teno,+Joan+M.;+Clarridge,+Brian+R.;+Casey,+Virginia;+Welch,+Lisa+C.;+Wetle,+Terrie;+Shield,+Renee;+Mor,+Vincenten
dc.identifier.urihttp://dx.doi.org/10.1001/jama.291.1.88en
dc.identifier.urihttp://hdl.handle.net/10822/993301en
dc.description.abstractOver the past century, nursing homes and hospitals increasingly have become the site of death, yet no national studies have examined the adequacy or quality of end-of-life care in institutional settings compared with deaths at home. OBJECTIVE: To evaluate the US dying experience at home and in institutional settings. DESIGN, SETTING, AND PARTICIPANTS: Mortality follow-back survey of family members or other knowledgeable informants representing 1578 decedents, with a 2-stage probability sample used to estimate end-of-life care outcomes for 1.97 million deaths from chronic illness in the United States in 2000. Informants were asked via telephone about the patient's experience at the last place of care at which the patient spent more than 48 hours. MAIN OUTCOME MEASURES: Patient- and family-centered end-of-life care outcomes, including whether health care workers (1) provided the desired physical comfort and emotional support to the dying person, (2) supported shared decision making, (3) treated the dying person with respect, (4) attended to the emotional needs of the family, and (5) provided coordinated care. RESULTS: For 1059 of 1578 decedents (67.1%), the last place of care was an institution. Of 519 (32.9%) patients dying at home represented by this sample, 198 (38.2%) did not receive nursing services; 65 (12.5%) had home nursing services, and 256 (49.3%) had home hospice services. About one quarter of all patients with pain or dyspnea did not receive adequate treatment, and one quarter reported concerns with physician communication. More than one third of respondents cared for by a home health agency, nursing home, or hospital reported insufficient emotional support for the patient and/or 1 or more concerns with family emotional support, compared with about one fifth of those receiving home hospice services. Nursing home residents were less likely than those cared for in a hospital or by home hospice services to always have been treated with respect at the end of life (68.2% vs 79.6% and 96.2%, respectively). Family members of patients receiving hospice services were more satisfied with overall quality of care: 70.7% rated care as "excellent" compared with less than 50% of those dying in an institutional setting or with home health services (Pen
dc.formatArticleen
dc.languageenen
dc.sourceeweb:269492en
dc.subjectCommunicationen
dc.subjectDeathen
dc.subjectDecision Makingen
dc.subjectFamily Membersen
dc.subjectHealthen
dc.subjectHealth Careen
dc.subjectHealth Servicesen
dc.subjectHospitalsen
dc.subjectIllnessen
dc.subjectLifeen
dc.subjectMortalityen
dc.subjectNursing Homesen
dc.subjectPainen
dc.subjectPatientsen
dc.subjectProbabilityen
dc.subjectSurveyen
dc.subject.classificationFamily Attitudes Toward Deathen
dc.subject.classificationCare of the Dying Patienten
dc.titleFamily Perspectives on End-of-Life Care at the Last Place of Careen
dc.provenanceCitation prepared by the Library and Information Services group of the Kennedy Institute of Ethics, Georgetown University for the ETHXWeb database.en
dc.provenanceCitation migrated from OpenText LiveLink Discovery Server database named EWEB hosted by the Bioethics Research Library to the DSpace collection EthxWeb hosted by DigitalGeorgetown.en


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