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In 2022, 224,900 U.S. hospice beneficiaries were discharged alive, and 6.1% were discharged because they were “no longer being terminally ill.” This transition may reduce hospice-based supports and complicate decisions about re-enrollment. A purposive study of 32 patient-caregiver dyads used semi-structured interviews and thematic analysis to examine experiences of service coordination and post-discharge quality of life impacts.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/patient-and-caregiver-experiences-of-navigating-the-seesaw-of-hospice-live-discharge/422057/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/patient-and-caregiver-experiences-of-navigating-the-seesaw-of-hospice-live-discharge/422057.png","ImageObject",300,407,{"name":92,"@type":93},"Mimi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why does hospice live discharge create an eligibility and support challenge?","Question",{"text":113,"@type":114},"Hospice live discharge can change Medicare inpatient eligibility based on the prognostic requirement of 6 months or less. It may also lead to losing important hospice-based supports and raises questions about whether re-enrollment is needed.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the study conducted to understand patient and caregiver experiences?",{"text":118,"@type":114},"The study used a purposive sample of 32 patient-caregiver dyads. In-depth semi-structured interviews were analyzed using thematic analysis to identify recurring experience patterns.",{"name":120,"@type":111,"acceptedAnswer":121},"What does the study mean by the “seesaw” experience?",{"text":122,"@type":114},"Participants described navigating ups and downs, including uncertainty about maintaining eligibility after discharge. Caregivers also expressed doubts about how patients “get better” enough for discharge and whether discharge was necessary or appropriate.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},422057,1791086175,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":81,"preview_page_count":4},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","586 Innovation in Aging, 2025, Vol. 9, No. S2  \nsuggest a need to develop and examine robust services to support patient and caregiver transitions from hospice care.  \nAbstract citation ID: igaf122.2009  \nPATIENT AND CAREGIVER EXPERIENCES OF  \nNAVIGATING THE “SEESAW” OF HOSPICE LIVE  \nDISCHARGE  \nCara Wallace1, Stephanie P. Wladkowski2, Todd Becker3, Joseph Trinitas4, Ruaa Al Juboori5, Leslie Hinyard6, and Verna Hendricks-Ferguson7, 1. Saint Louis University, Saint Louis, Missouri, United States, 2. Bowling Green State University, Bowling Green, Ohio, United States, 3. WashU Medicine, St. Louis, Missouri, United States, 4. Saint Louis University, St. Louis, Missouri, United States, 5. University of Mississippi, Oxford, Mississippi, United States, 6. Saint Louis University School of Medicine, St. Louis, Missouri, United States, 7. Trudy Busch Valentine School of Nursing, St. Louis, Missouri, United States  \nThe receipt of quality hospice care may prompt changes inpatient eligibility under Medicare’s prognostic requirement of 6 months or less. In 2022, 224,900 hospice beneficiaries across the United States were discharged alive from hospice care, with 6.1% discharged due to “no longer being terminally ill.” This critical care transition is associated with losing important hospice-based supports and questions if to re-enroll back onto hospice care.  \nPrevious research is limited on how patients and caregivers navigate countervailing positive and negative reactions that shape this phenomenon. The current study aimed to address this gap by exploring the experience of service coordination and potential impacts to quality-of-life post-discharge. With a purposive sample of 32 patient-caregiver dyads, in-depth, semi-structured interviews were analyzed via thematic analysis. Results were characterized by navigating a process of ups and downs with varying questions about whether the patient was maintaining eligibility, akin to a seesaw. Specifically, caregivers described an uncertainty regarding how hospice patients managed to “get better” to warrant discharge, when their needs for assistance remained the same. Other caregivers cast doubt on if discharge was necessary or even appropriate. Whereas nearly half of participants referred to live discharge as incongruent with their goals for care, the experiences associated with navigating live discharge (both positive and negative) led others to question if they would want the patient to re-enroll in hospice in the future. These results","cbCairq54Ho3oJeO","https://ap.wps.com/l/cbCairq54Ho3oJeO","pdf",543427,"English","# Study background\n## Medicare eligibility and hospice discharge impact\n# Research gap and aim\n## Service coordination and post-discharge quality of life\n# Methods\n## Purposive sample and semi-structured interviews\n## Thematic analysis\n# Key findings\n## Navigating uncertainty and a “seesaw” of reactions\n## Questions about eligibility, appropriateness, and re-enrollment","[{\"question\":\"Why does hospice live discharge create an eligibility and support challenge?\",\"answer\":\"Hospice live discharge can change Medicare inpatient eligibility based on the prognostic requirement of 6 months or less. It may also lead to losing important hospice-based supports and raises questions about whether re-enrollment is needed.\"},{\"question\":\"How was the study conducted to understand patient and caregiver experiences?\",\"answer\":\"The study used a purposive sample of 32 patient-caregiver dyads. In-depth semi-structured interviews were analyzed using thematic analysis to identify recurring experience patterns.\"},{\"question\":\"What does the study mean by the “seesaw” experience?\",\"answer\":\"Participants described navigating ups and downs, including uncertainty about maintaining eligibility after discharge. Caregivers also expressed doubts about how patients “get better” enough for discharge and whether discharge was necessary or appropriate.\"}]","Patient and Caregiver Experiences of Navigating the “Seesaw” of Hospice Live Discharge | PDF",1790626136]