PURPOSE: This study was performed to assess the knowledge, attitudes, and experiences with viatical settlements among hospice staff who provide financial counseling to terminally ill patients and their families. DESCRIPTION OF STUDY: A random sample of 300 hospices in the 50 states was selected from the National Hospice Directory. Staff members who provide financial counseling to patients and families were interviewed by phone using a 31-item structured questionnaire. RESULTS: The response rate was 80%. The results showed that only 4% of hospices provide information about viatical settlements to all patients, while 32% provide information only if asked. Only 9% of respondents rated themselves is very informed about viatical settlements, and 53% rated themselves as moderately infomred. Of the 47 hospices where at least one patient had used a viatical settlement, 92% felt the patient had a positive experience using the resource. In response to a hypothetical case of a terminally ill patient considering a viatical settlement, 40% responded positively, while 51% were neutral. CLINICAL IMPLICATIONS: Among hospice financial counselors who have had experience with viatical settements, most report positive experiences. When asked to respond to a hypothetical case, most respondent were either neutral or positive. However, lack of knowledge about viatical settlements may limit the avaibility of this resource for terminally ill patients and their families.
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