Challenges to Providing End-of-Life Care to Low-Income Elders With Advanced Chronic Disease: Lessons Learned From a Model Program

B. J. Kramer, C. Auer
2005 The gerontologist  
Purpose: This study explored the challenges in providing end-of-life care to low-income elders with multiple comorbid chronic conditions in a fully "integrated" managed care program, and it highlighted essential recommendations. Design and Methods: A case-study design was used that involved an extensive analysis of qualitative data from five focus groups with interdisciplinary team members, two in-depth interviews with administrators, and open-ended survey responses from social workers
more » ... death experiences of 120 elders. Results: Seven major themes characterized primary end-of-life care challenges: (a) the nature of advanced chronic disease; (b) the incapacity of support systems; (c) barriers to honoring care preferences; (d) challenges with characteristics and needs of participants; (e) needs of complex family systems; (f) barriers with transitions; and (g) barriers with culture and language. Implications: The lessons learned suggest recommendations with implications for program development, practice, policy, and future research.
doi:10.1093/geront/45.5.651 pmid:16199400 fatcat:cno2v4cpqvag3gnkp7fypuxrkm