Wladkowski Stephanie P, Hunt Lauren J, Luth Elizabeth A, Teno Joan, Harrison Krista L, Wallace Cara L
College of Health and Human Services, Bowling Green State University, Bowling Green, Ohio, USA.
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA.
J Palliat Med. 2024 Sep 18. doi: 10.1089/jpm.2024.0337.
Hospice care is designed to support the medical and psychosocial needs of individuals with serious illness and their caregivers through the dying process. Some individuals, though, leave hospice prior to death, generally referred to as disenrollment or a "live discharge." Live discharge from hospice is a common and often distressing issue for hospice patients, their caregivers, and also for hospice professionals and agencies. This paper discusses common issues surrounding live discharge that clinicians and other healthcare professionals should consider when dealing with live discharge in their own clinical practices. Where applicable, we provide practical steps for hospice and palliative care clinicians to better support patients and families through this critical care transition. Further, we offer strategic directions interprofessional clinicians can take to affect systemic change to improve live discharge experiences.
临终关怀旨在在临终过程中满足重症患者及其护理人员的医疗和心理社会需求。然而，一些患者在死亡前就离开了临终关怀机构，通常被称为退出或“存活出院”。临终关怀机构的存活出院对临终关怀患者、他们的护理人员以及临终关怀专业人员和机构来说都是一个常见且往往令人痛苦的问题。本文讨论了围绕存活出院的常见问题，临床医生和其他医疗保健专业人员在自己的临床实践中处理存活出院时应予以考虑。在适用的情况下，我们为临终关怀和姑息治疗临床医生提供了切实可行的步骤，以便在这一关键的护理过渡过程中更好地支持患者和家庭。此外，我们还为跨专业临床医生提供了战略方向，他们可以采取这些方向来推动系统性变革，以改善存活出院体验。
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