How should clinicians describe hospice to patients and families

摘要: Objectives: To describe hospice enrollment from the perspective of bereaved family members and to identify information about that would encourage patients families enroll sooner. Design: Cross-sectional interviews. Setting: Three Medicare-certified organizations. Participants: One hundred 100 who died in hospice. Measurements: Semistructured interviews assessed prior knowledge hospice, patients' physicians' involvement process, features motivated enrollment, wished they had learned sooner. Results: Almost all (n=92) (n=71) knew before patient's illness. half (n=44) were not involved at decision. The physician (n=51) or patient (n=34) initiated most discussions, but usually obtained a representative (n=75) rather than (n=22). Family identified several kinds particularly helpful deciding whether described aspects known sooner. Conclusion: Many learn someone other physician, valuable services only after enrollment. By providing more earlier illness course, clinicians may be able facilitate more-informed more-timely decisions