title: Remaining in the nursing home versus transfer to acute care: resident, family, and staff preferences.
abstract: Resident and family insistence on transfer is a major factor in the occurrence of potentially avoidable transfers from nursing homes (NHs) to acute care. The purpose of this study was to explore resident, family, and staff preferences regarding transfer to acute care. A sample of 271 NH residents, family members, staff, and medical providers were interviewed. Seventy-seven percent of residents reported that they had not given any thought to the question of whether they would want to be transferred to acute care. Family members wanted more information than residents, but more residents (39%) thought they should be fully involved in the transfer decision than their family members (12%) or staff (12%). Staff preferred keeping residents in the NH. Families were divided between transferring residents and having them remain in the NH. More residents indicated that their desire to transfer would depend on the severity of their condition and their prognosis. Ethnic group differences were noted. Results suggest that discussion of this issue should occur soon after admission and that differences in perspectives may be expected from those involved.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Tappen
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Worch
authors.forename: Deborah
authors.initials: D
authors.lastname: Elkins
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Hain
authors.forename: Christine M
authors.initials: CM
authors.lastname: Moffa
authors.forename: Gail
authors.initials: G
authors.lastname: Sullivan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003422:Critical Care; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D005851:Geriatric Nursing; D006707:Homes for the Aged; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D010360:Patient Transfer; D017410:Practice Guidelines as Topic