Changes in Hospice Care Experiences During the COVID-19 Pandemic

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Demand for hospice care increased during the COVID-19 pandemic.  Hospices worked to meet this increased demand while experiencing staffing shortages and visiting restrictions that prevented both caregivers and hospice staff from visiting clients in some settings such as long-term care homes and hospitals.

DeYoreo and colleagues (2023) examined how the COVID-19 pandemic may have influenced the characteristics of patients receiving hospice care, the settings in which they received care, and their care experiences in the United States.  They analyzed data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey, which is is completed by bereaved family caregivers following the death of the hospice patient.

The impact of the pandemic on caregiver-reported care experiences was estimated using an average of eight measures from the CAHPS Hospice
Survey, including: hospice team communication, respectful treatment, emotional and spiritual support, timely care, help for symptoms, training family to care for the patient at home, and overall rating and willingness to recommend the hospice.  The study included responses from 1,892,944 caregivers whose family members received care from 3274 hospices across the United States from the first quarter of 2016 through the fourth quarter of 2021.

Characteristics of hospice decedents were similar in post-2019 to pre-pandemic time periods.  The setting of care shifted toward home settings and away from other settings.

Overall, estimated pandemic effects on reported hospice care experiences were small.  All settings except home saw decreases in the percent of caregivers who reported “always” being involved in care. Post-pandemic changes in care experiences varied by setting, with a small negative impact noted in the home setting, with larger negative changes in nursing homes, assisted living facilities and in-patient hospices.  The largest negative impact was seen in hospital settings.

Source: DeYoreo, M., Anhang Price, R., Haas, A., Tolpadi, A., Teno, J. M., & Elliott, M. N. (2023). Changes in hospice care experiences during the COVID‐19 pandemicJournal of the American Geriatrics Society.