End-of-life care in U.S. nursing homes: a review of the evidence.
OBJECTIVE
The purpose of this study was to systematically review the empiric evidence on end-of-life care in nursing homes in the United States The guiding research question for this review was what is the state of research evidence in end-of-life care in long-term care?


METHODS
We conducted a systematic review of the literature.


METHODS
The review was limited to published and indexed research in peer-reviewed journals in five major databases between 1995 and October 2002.


RESULTS
The initial search yielded a total of 395 articles. The search was narrowed, focusing on nursing homes in the United States and empiric research. The result was 43 articles related to research in end-of-life care in American nursing homes. It was categorized into eight foci: prognosis, pain, hospice, hospitalization, advanced care planning, communication, family perceptions, and miscellaneous.


CONCLUSIONS
There is a dearth of research published in end-of-life care in the nursing home setting. What is available is primarily descriptive. The empiric research only documents poor end-of-life care in U.S. nursing homes. Empiric evidence has grown in this area, but there is now a need for research of creative and innovative solutions aimed at improving the quality of end-of-life care in this setting.
Oliver
Debra Parker
DP
School of Social Work, University of Missouri-Columbia, Columbia, MO 65212, USA. oliverdr@missouri.edu
Porock
Davina
D
Zweig
Steven
S
D006301:Health Services Needs and Demand; D006801:Humans; D009735:Nursing Homes / Q000592:standards*; D010166:Palliative Care / Q000379:methods*; D011787:Quality of Health Care; D013727:Terminal Care / Q000379:methods*; D014481:United States