title: The challenge of providing palliative care in the nursing home: part 1 external factors.
abstract: One impact of the baby boom generation and improved medical care is that nursing homes will be the place of care and site of death for growing numbers of frail, older persons dying of chronic progressive illnesses. The nursing home settings may appear to be an appropriate environment wherein residents could receive palliative care, but the literature suggests that provision of such care is replete with challenge. Some of these challenges are external to the nursing home environment and are beyond the setting's control, others have internal origins and to some extent may be under the home's control. In part I of this two-part article, we review and critically analyse the primary external factors identified in the literature -- characteristics of the residents -- as they impact on the ability of care homes to deliver palliative care.
authors.affiliation: Winnipeg Regional Health Authority Palliative Care Program, A8024409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada. swowchuk@wrha.mb.ca
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Wowchuk
authors.forename: Susan
authors.initials: S
authors.lastname: McClement
authors.forename: John
authors.initials: J
authors.lastname: Bond
mesh_terms: D000203:Activities of Daily Living; D032722:Advance Care Planning; D000368:Aged; D001315:Australia; D002908:Chronic Disease; D018450:Disease Progression; D016330:Frail Elderly; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D006301:Health Services Needs and Demand; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D009656:North America; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009735:Nursing Homes / Q000458:organization & administration*; D010166:Palliative Care / Q000458:organization & administration*; D011158:Population Growth; D006113:United Kingdom