Evidence map›Paper›PMID 33454147›Full record

ArticlePatient education and counseling2021

Live hospice discharge: Experiences of families, and hospice staff.

Margaret F Clayton, Rebecca Utz, Eli Iacob, Gail L Towsley, Jacqueline Eaton, Hollie J Fuhrmann, Kara Dassel, Michael Caserta, Katherine Supiano

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Patient education and counseling, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Live Hospice Discharge of Individuals with Cognitive Disabilities: A Systematic Review.Journal of the American Medical Directors Association · 2025
    Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Predicting hospice eligibility among dementia patients using language models.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  7. Article
  8. Article
  9. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Margaret F ClaytonCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA. Electronic address: Margaret.clayton@nurs.utah.edu.
Rebecca UtzDepartment of Sociology, University of Utah, 390 1530 E #301 Salt Lake City, UT, 84112, USA.
Eli IacobCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Gail L TowsleyCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Jacqueline EatonCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Hollie J FuhrmannCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Kara DasselCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Michael CasertaCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Katherine SupianoCollege of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
University of Utah · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
NCATS NIH HHS UL1 TR001067NCATS NIH HHS UL1 TR002538
6 · The paper itself

Abstract

objectiveTo examine live hospice discharge prevalence and experiences of families and hospice staff. Hospice eligibility is based on a cancer model where decline and death are predicable. Decline is less predictable for diagnoses such as dementia, frequently resulting in involuntary live hospice discharge.

methodsA mixed-method integration of hospice 2013-17 admission/discharge data, 5 family interviews, hospice discipline-specific focus groups (3 aides, 2 nurses, 1 administrator interview) and a discipline-combined focus group (all 6 staff; each staff participant engaged in two data collection experiences).

results5648 hospice admissions occurred between 2013-17; 795 patients experienced live discharge. The most prevalent admitting diagnosis was cancer, the most prevalent live discharge diagnosis was dementia. Family caregiver themes were Attitude and experience with hospice, Discharge experience, and Continued need/desire for hospice following discharge. Staff themes were Discharge circumstances, Regulatory guidelines, and Changing practice to meet regulatory guidelines.

conclusionInvoluntary live hospice discharge precludes patient-centered care due to policy constraints, especially for those with noncancer diagnoses. Families and staff noted the paradox of beneficial hospice care, yet this care resulted in ineligibility for continued hospice services. PRACTICE IMPLICATIONS: Transparent, patient-family-staff communication (including CNAs) facilitates hospice live discharge planning. Hospice service eligibility policy changes are needed.

Indexed as

Hospice CareHospicesCaregiversHospitalizationHumansPatient DischargeAlzheimer's disease and related dementiasCancerCaregiversHospiceHospice staffLive hospice dischargeNurse aidesPatient and family centered carePolicy

Identifiers

PMID33454147
PMCPMC8726000
OpenAlexW3119408859

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.