Comparison of the high-tech service delivery experiences of hospice and non-hospice home health providers.

This study examined the degree to which national samples of hospice and non-hospice home health care agencies (N = 154) present different organizational profiles and grapple with different patient capacity issues when delivering technology-enhanced services to incapacitated elderly. Hospice agencies employ more part-time staff, make more in-home visits, see more high-tech patients, and provide a wider range of high-tech services than non-hospice providers. Factor analysis of index data confirms that hospice staff have more experience (p < .05) addressing the legal/ethical dimensions of care. Specifically, hospices deal with "right to die" issues more often (p < .05), but not with "delegation of authority" and "patient rights" issues. More agencies of both types have policies for handling decisions about life-sustaining treatment than for dealing with patients having questionable decision-making capacity. Needed agency policies for dealing with limited patient decision-making capacity in hospice and non-hospice home care agencies are reviewed.