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Challenges in the transfer of patients from hospice to nursing home: a model for future partnership
  1. Polly Traxler
  1. The Hospice of St Francis, Berkhamsted, UK

Abstract

Introduction Transfer of patients to nursing homes for end of life care is often difficult. Patients and carers express anxiety and feelings of abandonment during the process. At The Hospice of St Francis we reviewed 10 hospice discharges in order to plan the introduction of transitional support volunteers to regularly visit patients and carers following transfer. Data is presented from our review of 10 discharges to nursing homes.

Aims

  • To identify if there are predictable /repeated issues causing distress in the transfer process.

  • Whether continued involvement of a ‘familiar face’ would benefit a patient/carer in the transfer process.

  • To work in partnership with nursing homes to reduce transitional anxiety.

Method We reviewed 10 discharges from The Hospice of St Francis to 5 nursing homes (Aug ‘10 – March ‘11). Focusing on timeliness, carer/relative involvement and stage of illness at transfer.

Results The hypothesis is:

  • The greater the involvement of carer/relatives the longer the transfer process

  • All of the patients/relatives expressed some level of anxiety with the process

  • For some anxiety and feelings of abandonment intensified post transfer leading to a move within days to another care setting.

Discussion The analysis of 10 discharges from the Hospice to nursing homes highlighted that both clinical and psychosocial issues contribute to transitional anxiety. Nursing home staff welcome support in addressing the psychosocial needs of people at the end of life.

Conclusion Hospice care should not end once a person moves to a nursing home. We should focus more on reducing feelings of abandonment/loneliness for patients/carers transferred to nursing homes. The Hospice of St Francis Hospice will pilot a ‘transitional volunteer service’ for 12 months from May 2011 to May 2012.

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