ARTICLEHOME HEALTH CARE MANAGEMENT & PRACTICE / June 2003 Caring for Patients in an Inner-City Home Hospice: Challenges and Rewards

This article describes the work of the Johns Hopkins Home Hospice, with a focus on the inner-city patients who make up much of its popu-lation. Through interdisciplinary teamwork, the hospice strives to provide these patients with the same high-quality end-of-life care as those in more affluent areas receive. Particular care chal-lenges in the inner city include finding staff mem-bers and volunteers who are comfortable working in this environment and ensuring their safety and working with families that may have limited resources. Nurses, physicians, and aides may have to work to overcome barriers to pain man-agement and caregiving. Volunteers often play a special role in caring and companionship. Social workers may need to overcome negative percep-tions of the social work role and be accepting of different views of support networks. Spiritual caregivers need to work in the patients ’ cultural context, and bereavement coordinators often deal with disenfranchised grief and multiple losses