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Another study about how palliative care fails minorities was recently released, adding to what seems like mounting evidence that hospice and others involved in end-of-life care are failing to meet the needs of African-Americans, including understanding the cultural factors that play a role in patients perception of pain.
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The number of terminally ill patients enrolled in Americas hospices continues to rise, now topping 700,000 per year. But growth in patient enrollment has been counterbalanced in recent years by declining lengths of stay. The net result for many hospices has been stagnating average daily census, a more telling measure of actual growth.
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Like two trains steaming full-speed toward each other, the growing aging population and the continuing shortage of nurses and other providers threaten to come crashing together, derailing whatever progress hospices make toward increasing access to their services.
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Paying attention to a myriad of small signs in both the caregivers and the patients behavior can alert the home health nurse to a need for intervention to prevent caregiver burnout.
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This is the first of a two-part series that examines family caregiver issues such as education, stress, burnout, and support. In this article, experts talk about the educational needs of family caregivers and how a home health nurse can recognize caregiver burnout.
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After more than 20 years of Medicare reimbursement for hospice care, the industry has become preoccupied by clinical indicators and local medical review polices that offer guidelines for hospice admission. Too often a prospective hospice patient is defined by clinical indicators, rather than by the psychosocial characteristics that affect the quality of ones death.
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Even though hospice care touches the lives of more than 800,000 Americans with life-threatening illnesses and their families per year, many critics have questioned the dominant payment mechanism for such care, the Medicare Hospice Benefit, which was implemented 20 years ago this November.
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It seems every new decade brings another twist to financing health care. Over the past 30 years, terms such as managed care, diagnosis-related groups, and capitation have become part of the health care industry lexicon. Now come consumer-directed health plans.
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