Date of Conferral

2017

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Cassandra Taylor

Abstract

Hospice services are utilized by more than 1.6 million people yearly, and there are a great number of caregivers who are tasked with caring for these individuals at home. Caregivers are at risk for fatigue, burnout, and decline in their own physical and mental health. While the Centers for Medicare and Medicaid Services (CMS) cover costs of temporary respite care for hospice patients, the caregivers' needs for respite care are often unrecognized and unaddressed. The purpose of this project was to plan a respite program within the hospice agency consisting of revised respite policy and procedures, the Caregiver Reaction Assessment (CRA) tool to routinely assess the caregiver for burnout and/or fatigue, and a detailed outline for the implementation of respite care. Anderson's behavioral model of service was used to guide the project's understanding of the underutilization of respite services. This project was guided by the practice-focused question examining the development of an evidence based caregiver respite program within the hospice agency. The program was developed based on a review of peer reviewed research studies and the input of a project team of local experts. The project team participated in the project that created a respite policy which includes a biweekly caregiver assessment and step-by-step directions on how to implement respite care. A final report was developed and submitted to the Hospice agency. This revised policy and procedure includes a blueprint for implementation and a full set of recommendations on the process, use of the CRA, educational in-services, and evaluative methods. These recommendations have the potential for positive social change by increasing patient and caregiver outcomes, serving as an example for other hospice agencies to follow, and improving care at the end of life.

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