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How do enrollees feel about support in Big Hospices? – The caregiver experience of emotional, spiritual, and bereavement support by profit status among large US providers

Published online by Cambridge University Press:  08 April 2024

Jason T. Hotchkiss Open the ORCID record for Jason T. Hotchkiss [Opens in a new window] ,
Emily Ridderman  and
Brendan T. Hotchkiss
Jason T. Hotchkiss*
Affiliation:
Department of Professional and Graduate Studies, Cornerstone University, Grand Rapids, MI, USA
Emily Ridderman
Affiliation:
Department of Professional and Graduate Studies, Cornerstone University, Grand Rapids, MI, USA
Brendan T. Hotchkiss
Affiliation:
Chabot College, Hayward, CA, USA
*
Corresponding author: Jason T. Hotchkiss; Email: jason.hotchkiss@cornerstone.edu
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Abstract

Objectives

Recent findings narrate profiteering detrimentally impacting hospice care quality. However, no study has examined the caregiver experience of emotional and spiritual support expressed online. The purpose was to evaluate the hospice caregiver’s experience of emotional, spiritual, and bereavement support and whether the care was respectful and compassionate to the care unit.

Methods

Retrospective mixed methods of sentiment and quantitative analysis. Sources were online caregiver reviews (n = 4,279), Consumer Assessment of Healthcare Providers and Systems (CAHPS) data on the 50 largest US hospices.

Results

Caring and compassionate professionals were lauded in nonprofit (+.57) and for-profit settings (+.46). The nonprofit experience was in the excellent range (+42) for emotional, spiritual, and bereavement support but fell to dissatisfying (–.15) among for-profits. A respectful experience (16%) was much less commonly expressed than a compassionate one (38%). Distribution of CAHPS “Treating patient with respect” (M = 89.62, SD = 2.63) and “Emotional and spiritual support” (M = 89.80, SD = 2.04) limited inter-hospice comparisons.

Significance of results

Compassionate professionals were thanked and praised regardless of profit status. Sadly, anger was expressed toward large, for-profits more fixated on census than emotional, spiritual, and bereavement support; thankfully nonprofits were more supportive. CAHPS items for “Treating patient with respect” and “Emotional, spiritual support” offer limited discriminating value since low CAHPS performers always had relatively high scores on these 2, yet otherwise low scores on the remaining 6. Online reviews on the same topics provide a more substantive and realistic appraisal – distinguishing high from low performers. A higher bar than mere respect is needed for the tender experience of death, dying, and grieving. Compassion is an especially relevant addition to CAHPS since caregivers named compassionate staff as a distinguishing factor. Parity for mental health at end of life is a vital research topic. Future research should also explore the caregiver expectations set on admission.

Keywords

Big Hospicecaregiver experienceemotional supportspiritual supportprofit statusCAHPS® scoresConsumer Assessment of Healthcare Providers and Systems
Type
Original Article
Information
Palliative & Supportive Care , First View , pp. 1 - 21
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Copyright
© The Author(s), 2024. Published by Cambridge University Press.

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