RACIAL DIFFERENCES IN LOCATION BEFORE HOSPICE ENROLLMENT AND ASSOCIATION WITH HOSPICE LENGTH OF STAY. Felicia Holden
ITT-Technical Institute
NU110
05/13/2014

(1) The overall purpose or overview of this article was to inform the reader that there is a racial difference for patients being admitted to hospital in a timely manner due to location and referrals. African Americans have a higher admission rate into hospice from a hospital setting due to being admitted through the ER versus being referred by a primary Doctor early to receive appropriate hospice services. According to this article white patients are more likely to receive a referral to hospice from their primary MD due to attending doctor’s visits and follow up with appropriate procedures. White patients find out their prognosis and are able to get a full understanding that they no longer are in curative stages for the disease process and need to be referred to hospice for symptom and pain management. White patients in a home setting and nursing home setting receive hospice care and are likely to obtain all the hospice care for a longer time than African Americans. According to this article African Americans are least likely to receive a referral based on not following up on MD visits, personal beliefs about disease process and their faith. African Americans are admitted to hospitals after a admission through an ER and once their prognosis is determined to be end-of-life care. A lack of knowledge due to not going to their MD and finding out that their disease has worsened and curative measurements are not appropriate for them any longer. So therefore they receive a shorter stay in hospice because they are imminent upon admission to hospice and their disease process has progressed to hasten death. Also it has be proven the same outcome for white people who are admitted to hospice at a hospital and they are also imminent upon admission to hospital and they die at the same rate as African Americans who are admitted to hospice during a hospital visit.
(2) Why was the article chosen/of interest to you? I once worked as a hospice nurse and I will agree with the article. I experienced on many occasions where Africans Americans were admitted to hospice from a hospital and would pass the same day of admission or 1-2 days of admission never getting a chance to receive music therapy, social services, chaplain visit, and a nursing staff visit. I would receive a call soon after the patient was admitted to hospice to come pronounced the time of death for a African American admitted to hospice within a week of admission. I saw how the families were overwhelmed and wasn’t prepared or educated on the death and dying process. I was interested in reading this article to find out the outcome of this case study and was not surprised to find out that white people were referred appropriately due to keeping up with MD visits and African Americans were not.
(3) Pros and cons of this article (Was it helpful, easy to understand or difficult to grasp the concept?) I feel this article was well written and did a good job of supporting the research obtained during this observation. I felt that the article did a good by informing readers that African Americans are not being discriminated based on skin color from hospice. It’s based on how African Americans are being referred to hospice that determines the length of stay on hospice. I would have to agree with hospital. I had a family member who had lung cancer and continued to smoke cigarettes and never went to the MD for follow up or never received chemotherapy or radiation treatment. This family member became very sick and then went to the ER and at that time it was discovered that the cancer has travel and the prognosis was very poor. My family member was admitted to hospice that very day and died within two days. So I would agree with the findings of this article.
(4) What did you learn from this article? I learned that all