Home Care for Elderly Persons Linkages Between Formal and Informal Caregivers Prior research has generally focused on characteristics of elderly persons that predict contact with community services or the volume of services used. In contrast, this study investigates how personal care and home health services are used in relation to assistance from primary kin caregivers. A typology was developed based on task sharing or segregation between kin caregivers and service providers, and four types of informal-formal linkages around these tasks were identified: kin independence, formal service specialization, dual specialization, and supplementation. Findings regarding predictors of the types showed that caregiver and care recipient variables were most significant in differentiating among them, although caregiver gender also had some discriminatory power. Read more
Criteria for Admission to Detoxification Treatment Factors Influencing Staff Judgments This paper examines the formal triage process used by an alcohol/drug detoxification center to determine a client’s need for treatment. The analysis tests various types of client characteristics for their influence on admission decisions. In accord with the policy of the agency and the medical model of addiction, symptoms of acute physiological withdrawal should determine whether a client is admitted for treatment during the triage period. Societal reaction theory presents an alternative perspective suggesting that a person’s history of substance abuse and socio-demographic characteristics will influence the likelihood of admission into a treatment program. Results offer support for both a medical model and societal reaction approach in the physiological withdrawal symptoms, history of abuse characteristics, and socio-demographic makeup each independently influence staff’s assessment of the need for treatment. Read more
The Hospice Ideology and Success of Hospice Care Hospice is a concept of terminal care based on an ideology that specifies a particular way for patients and families to deal with death and dying. This article describes this ideology and attempts to assess its success for hospice patients. Finding show that hospice care is more successful for patients who are more aware of their terminal status, who are older, and who have a primary caregiver who experiences fewer difficulties with the caregiver role. Read more
Social Determinants of the Passage to Hospice Care Entering a hospice program signifies an important transition in the career of a patient's illness. This study identifies several social factors which influence when during the illness career patients are labeled terminally ill and promoted to hospice care. A multiple regression analysis performed on data from 726 hospice patients shows the relative survival rate of the patient's primary disease, the number of family members or friends who assist with patient care, race of the patient, and the specialty area of the patient's primary physician explain significant variation in the timing of when patients are labeled terminally ill and admitted to hospice programs. The effects of these variables are calculated while controlling for the physical condition of the patient. Read more
Characteristics of Hospice Patients and Their Caregivers This study describes selected characteristics of a group of terminal patients who were enrolled in a home-based hospice program. Similar characteristics of the patients' primary caregivers also are described. Relationships between the characteristics of patients and caregivers are examined, as are relationships between these characteristics and the rate at which various services were utilized. Implications for hospice service delivery and for future hospice research are explored. Read more
The needs of hospice patients and primary caregivers While much has been written about the needs of terminally ill patients and of those who provide care for them, little empirical research has addressed this issue. Such research is required to enable hospice programs to evaluate the extent to which they are meeting their goals and to develop adequate programs of care. For this study, a list of ten need categories for patients and five need categories for primary caregivers were developed out of a review of relevant literature. Primary caregivers and nurses were asked to rank the importance of these needs for patients and for caregivers. There was a high degree of congruence between the rankings of caregivers and nurses at the beginning of hospice care; A second measure taken after the patient’s death showed that the level of congruence increased over the course of hospice treatment. Read more
