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Journal of Social Work
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Questioning the Evidence for Service Assumptions

Audit of Transfers from a Hospice to Nursing Home Care

Margaret Reith

Princess Alice Hospice, Esher, England, margaretreith{at}pah.org.uk

Caroline Lucas

Princess Alice Hospice, Esher and Ashford and St Peter's Hospitals NHS Trust, England, carolinelucas{at}pah.org.uk

• Summary: This article reports an audit of people considered for transfer from a hospice to a nursing home for end-of-life care and discusses implications for patients, families and staff.

• Findings: Moving patients to nursing homes at the end of their lives is often distressing for both patients and families and in many cases patients die within a short time of transfer. Few patients are actually transferred although many more are asked to face this possibility often creating unnecessary anxiety. This may have adverse consequences for family members' bereavement.

• Applications : There is a weak evidence base for transferring patients from hospices to nursing homes. Palliative care services assume a short in-patient stay to ration an expensive scarce resource. Assessment with social work contributions identifying complex emotional, family and bereavement consequences may allow multidisciplinary teams to justify longer hospice stays by identifying more complex needs to justify better substantive equality between patients.

Key Words: assessment • bereavement • hospice • nursing homes • palliative care

Journal of Social Work, Vol. 8, No. 3, 233-245 (2008)
DOI: 10.1177/1468017308091038
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