title: Partnering with hospice to improve pain management in the nursing home setting.
abstract: People are living longer but are dying with more disabilities, often in nursing homes. Identification of those who are dying needs to be quicker to allow discussion of goals of care and to meet their individual needs at a higher level. Pain is pervasive and undertreated in general, but institutionalized individuals are even at greater risk of receiving inadequate analgesia. Competing goals of providing good-quality palliative care while meeting federal and state expectations of improving or maintaining function can create dilemmas for those caring for terminally ill patients in nursing homes. Physicians play a critical role in improving communication between the family and the healthcare team during the transition from rehabilitative to palliative care. Hospice can be a valuable partner in the delivery of excellent pain and symptom management in end-of-life care.
authors.affiliation: Department of Geriatric Medicine/Gerontology, Ohio University College of Osteopathic Medicine, Athens, OH 45701-2979, USA. marx@ohiou.edu
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Marx
mesh_terms: D017051:Hospice Care / Q000379:methods* / Q000458:organization & administration / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D007373:Interinstitutional Relations; D008134:Long-Term Care / Q000331:legislation & jurisprudence / Q000592:standards; D009735:Nursing Homes / Q000331:legislation & jurisprudence / Q000458:organization & administration / Q000592:standards*; D059408:Pain Management; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D010348:Patient Care Team; D011368:Professional-Family Relations; D011787:Quality of Health Care; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D013727:Terminal Care / Q000379:methods* / Q000592:standards; D014481:United States