| It is estimated that 571,950 Americans will die from cancer in 2011. Hospice care is considered to be the model for quality end-of-life care for those facing terminal illnesses, focused on caring rather than curing. Yet, approximately 38.5% of all deaths in the United States in 2008 were under the care of a hospice program. Many who enroll in hospice do so in the last seven days of life and do not reap the benefits available to them. A review of literature identifies many barriers that exist to prevent or deter those with advanced cancer from enrolling in hospice. Among the barriers included are societal attitudes towards death and dying, physicians and other health care professionals, hospice organizations themselves as well as the laws, policies and regulations which govern them, and last, but certainly not least, the consumer. This study was designed to delve into the stories of eight different individuals with advanced cancer, four of whom chose to enroll in hospice at end-of-life and four who did not. Data was analyzed for pertinent themes. The significance of the themes and patterns that influence hospice decision-making from one particular clinical setting was identified and compared to those identified in the literature. This information in turn was useful to implement practice changes intended to facilitate informed decision making at end-of-life.;Keywords: barriers to hospice care for patients with terminal cancer, barriers to hospice enrollment, end-of-life discussions in terminal cancer, advanced practice nurses and end-of-life discussions... |
