Care for a Dying Patient: EMS Perspectives on Caring for Hospice Patients (F405A)

• Published in: Journal of pain and symptom management 2021-03, Vol.61 (3), p.647-648
• Main Authors: Wenger, Andrew, Potilechio, Megan, Aguilar, John, Mastenbrook, Joshua
• Format: Article
• Language: English
• Subjects: Advance directives; Caregivers; Caregiving; Desire; Emergency services; End of life decisions; Health services; Hospice care; Medical personnel; Paramedics; Patients; Polls & surveys; Terminal illnesses
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2021.01.026

Objectives 1. Recognize difficulties faced by EMS providers when caring for hospice patients. 2. Propose educational interventions to strengthen EMS provider understanding of hospice care. Original Research Background Emergency Medical Services (EMS) providers frequently encounter patients in end-of-life situations. These situations can become ethically challenging depending on the nature of the event, availability of advanced directives, and overall understanding of the situation by the patient and caregivers. This is particularly true for patients who are enrolled in Hospice, a specific form of end-of-life care available to patients with a terminal illness and expected lifespan of less than six months. Research Objectives This study aimed to survey Michigan EMS providers regarding encounters with hospice patients to better understand challenges caring for this population and any need for additional education. Methods An anonymous electronic survey was distributed via a statewide listserv to Michigan EMS providers. Responses were collected via RedCap. Descriptive statistics were calculated, and chi-square analyses performed. Results A total of 706 responses were received. Most respondents were paramedics (55%) or EMT-Basic (34%). In terms of caring for hospice patients, 96% indicated at least one encounter with a hospice patient and 66% had more than 10 encounters. Only 24% had received formal education on the care of hospice patients. A high percentage (86%) indicated interest in additional training in this area. Challenges identified among providers were inaccessible advanced directives (72%), pressure from family for more aggressive treatment (61%), and difficulty contacting hospice personnel (48%). Conclusion Only a small percentage of EMS providers have received formal training to navigate this unique and challenging patient population. Educational gaps may be narrowed with additional end-of-life specific curricular components, and EMS providers expressed a strong desire additional training. Implications for Research, Policy, or Practice EMS personnel provide important care for hospice patients but receive little training in caring for this special population. There is a strong desire for additional training improve provider-patient interactions.