Screening and Assessment of Substance Use in Hospice Care: Examining Content from a National Sample of Psychosocial Assessments.

Abstract Background: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. Objective: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers. Design/Measurements: Using a cluster random sample of U.S. Medicare-certified hospices, we reviewed blank copies of psychosocial assessments used by hospice social workers from 105 agencies. We conducted systematic content analyses of these assessments, identifying and examining all items related to substance use or addiction. Results: Over two-thirds (68%) of agencies assessed substance use by patient and/or family members. Assessments tended t...

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