Raising the standard: palliative care in nursing homes.
More than two-thirds of long-stay nursing home residents suffer from dementia. This illness has a variable and unpredictable course that renders it a poor fit for the six-month life-expectancy requirement of the Medicare hospice benefit. Palliative care-a form of treatment that strives to match care to patient goals, relieve pain, and improve quality of life for people with chronic or life-threatening illnesses-should be the standard of practice for all elderly dementia patients in nursing homes, regardless of prognosis. Similar principles could apply to other long-term residents with underlying chronic diseases who would benefit from palliative care. Indeed, we would argue that the growing acceptance of the culture-change movement centered on elder-directed goals in nursing homes is promising evidence of the goodness-of-fit of palliative care principles in the long-term care setting.
Meier
Diane E
DE
Mount Sinai School of Medicine, New York City, USA. diane.meier@mssm.edu
Lim
Betty
B
Carlson
Melissa D A
MD
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003704:Dementia / Q000628:therapy; D006299:Health Services for the Aged / Q000592:standards / Q000639:trends*; D017051:Hospice Care; D006801:Humans; D007342:Insurance Benefits; D008134:Long-Term Care / Q000458:organization & administration*; D009735:Nursing Homes / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D010166:Palliative Care / Q000592:standards*; D018802:Patient-Centered Care