Patient and caregiver factors |
- Inadequate symptom control (eg, pain; dyspnea).
|
- Malfunction or loss of support devices (eg, tracheostomy or gastrostomy tube).
|
- Stress, fear, or otherwise inability to cope with impending loss of life.
|
- Conflict about life-prolonging treatments. These may be treatments that were discontinued (eg, chemotherapy) or interventions that were never used (eg, hemodialysis).
|
- Patients and caregiver(s) have differing philosophies of care.
|
- Caregiver fatigue or inability to cope with patient needs.
|
- Automatic ingrained response to perceived patient distress.
|
Hospice-related factors |
- Failure or inability to address patient needs in a timely manner.
|
- Poor communication with the patient or family.
|
- Equipment failure without timely repair or replacement (eg, home oxygen or nebulizer).
|
- Call initiated by hospice (eg, unable to provide a specific type of care).
|