Chartbook on Person- and Family-Centered Care

• Hospice care is generally delivered at the end of life to patients with a terminal illness or condition who desire palliative medical care.
• Hospice care also includes practical, psychosocial, and spiritual support for the patient and family.
• The goal of end-of-life care is to achieve a "good death," defined by the Institute of Medicine as:

  …free from avoidable distress and suffering for patients, families, and caregivers; in general accord with the patients' and families' wishes; and reasonably consistent with clinical, cultural, and ethical standards (Field & Cassell, 1997).

End-of-Life Care Measures

• Hospice patients who received care consistent with their stated end-of-life wishes, by age and ethnicity, 2008-2013.
• Hospice patients who received the right amount of help for feelings of anxiety or sadness, by ethnicity and race, 2008-2013.
• Hospice patients who received the right amount of medicine for pain, by sex and race, 2008-2013.

Hospice Patient Care Consistent With End-of-Life Wishes

Hospice patients who received care consistent with their stated end-of-life wishes, by age and ethnicity, 2008-2013

• From 2008 to 2013, the percentage of hospice patients age 65 and over who received care consistent with their stated end-of-life wishes significantly improved from 94.4% to 95.1%. There were no statistically significant changes for the 18-44 and 45-64 age groups.
• From 2008 to 2013, White (94.7% to 95.6%) and Black (87.8% to 89.9%) hospice patients showed significant improvement, whereas Hispanics showed no statistically significant changes during this period.
• In 2013, hospice patients ages 18-44 were significantly less likely than patients ages 45-64 and age 65 and over to receive care consistent with their stated end-of-life wishes.
• In 2013, Black and Hispanic hospice patients were significantly less likely than White patients to receive care consistent with their stated end-of-life wishes.

Hospice Patients With Right Amount of Help for Anxiety or Sadness

Hospice patients who received the right amount of help for feelings of anxiety or sadness, by ethnicity and race, 2008-2013

• From 2008 to 2013, there were no statistically significant changes by ethnicity or race in the percentage of hospice patients who received the right amount of help for feelings of anxiety or sadness.
• In 2013, Hispanics and non-Hispanic Blacks were significantly less likely than non-Hispanic Whites to receive the right amount of help for feelings of anxiety or sadness.
• Also in 2013, Blacks, Asians and Other Pacific Islanders (APIs), and AI/ANs were significantly less likely than Whites to receive the right amount of help for feelings of anxiety or sadness.

Hospice Patients With Right Amount of Medicine for Pain

• From 2008 to 2013, the percentage of hospice patients who received the right amount of medicine for pain significantly improved for both sexes and for Whites.
• In 2013, Blacks, APIs, and AI/ANs were significantly less likely than Whites to receive the right amount of medicine for pain.

References

Field M, Cassell C, eds. Approaching death: improving care at the end of life. Washington, DC: National Academy Press; 1997.