Talks with families tied to fewer hospitalizations from nursing homes
Nursing homes that send fewer residents to the hospital at the end of life might do a better job of communicating with families about the pitfalls of aggressive interventions than other facilities, a recent U.S. study suggests.
At the end of life, hospital stays for seriously injured or ill nursing home residents typically offer little hope of improving quality of life or changing outcomes for the better, researchers note in JAMA Internal Medicine.
“We found that nursing home staff at all facilities encountered the same barriers to avoiding potentially burdensome hospitalizations, but that staff at low-hospitalizing facilities did two things very differently from those at high-hospitalizing ones,” said lead study author Dr. Andrew Cohen of Yale University in New Haven, Connecticut.
“They avoided decision-making algorithms and did not send patients to the hospital by default when an acute event occurred, and they viewed it as their role to try to change families’ minds when they requested a hospitalization that was unlikely to be beneficial,” Cohen added by email.
While previous research has found hospitalization rates generally tend to be lower at nonprofit nursing homes or at places with well-used hospice programs, less is known about what factors might influence the odds of hospital stays at the end of life at individual facilities, Cohen said.
To figure out what might happen inside individual nursing homes to impact hospitalization rates, researchers analyzed data from detailed interviews with staff at eight facilities with some of the highest and lowest hospitalization rates in Connecticut… Read More>>