YPSILANTI – An increasing number of patients who experience a live discharge from hospice services due to a stabilization in their condition are losing access to important services and resources.
Little is known about what happens to these patients post-hospice discharge, what their primary care needs are, or how patients and their primary caregivers attempt to meet those needs. This lack of understanding is particularly acute during the COVID-19 pandemic.
With that in mind, Stephanie Wladkowski, an associate professor in the Eastern Michigan University School of Social Work, and her research team of three colleagues from St. Louis have been awarded a National Institutes of Health Grant of nearly $430,000 over two years to study “The Impact of Live Discharge from Hospice on Patients & Caregivers.”
“The study aims to evaluate health and quality-of-life outcomes for patients and caregivers following the discharge from hospice care,” Wladkowski said. “The research team will also consider service utilization patterns, service coordination, and the quality and continuity of care transitions in the six months following the hospice discharge.”
Hospice care has been shown to improve end-of-life outcomes for adults with chronic illness, yet with eligibility limited, the system is not set up to accommodate longer term needs. Eligibility for hospice requires a patient to forgo curative treatments for his or her terminal condition and a physician to certify life expectancy of six months or less. Those adult patients who stabilize, or have a change in terminal prognosis, may be given a live discharge from hospice care.
In 2017, 6.7%, or nearly 90,000 hospice patients, were discharged after they no longer met eligibility requirements.
The six-month longitudinal survey will assess the quality of life, service utilization and health status for adult patients and their adult caregiver. The study will evaluate healthcare utilization and health status at time of live discharge and following a live discharge; determine service patterns and the continuity of care transitions; and analyze patient and caregiver perspectives on service coordination and potential impacts to quality of life.
Research that supported the successful grant proposal this year was a culmination of efforts sponsored by EMU, including the Provost’s Research Award, the Faculty Research Fellowship, the Summer Research/Creative Activity Award, and the Culture of Research Excellence (CoRE) Program (through the Office of Research Development and Administration) at Eastern.
This project also builds on recently published work on live discharge from hospice care between Wladkowski and principal investigator Cara Wallace, a professor at the Saint Louis University School of Social Work.
The research team also includes professor Verna Hendricks-Ferguson, the Irene Riddle Endowed Professor in the Trudy Busch Valentine School of Nursing at Saint Louis University; and Leslie Hinyard, Director of the Advanced HEAlth Data (AHEAD) Institute and Chair of the Department of Health and Clinical Outcomes Research at Saint Louis University.
Note: Maggie Rotermund of Saint Louis University contributed to this report.
About Eastern Michigan University
Founded in 1849, Eastern is the second oldest public university in Michigan. It currently serves more than 16,000 students pursuing undergraduate, graduate, specialist, doctoral and certificate degrees in the arts, sciences and professions. In all, more than 300 majors, minors and concentrations are delivered through the University's Colleges of Arts and Sciences; Business; Education; Engineering and Technology; Health and Human Services; and, its graduate school. EMU is regularly recognized by national publications for its excellence, diversity, and commitment to applied education. For more information about Eastern Michigan University, visit the University's website.