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Nursing home patients have hospice potential
Study shows patients don't elect hospice benefit
Nursing home residents can benefit from hospice services provided in the nursing home, according to Harvard Medical School researchers.1
Key findings reported in an article published in the Journal of Pain and Symptom Management found:
Hospice in nursing homes can provide high quality end-of-life care and offers benefits such as reduced hospitalizations and improved pain management.
The provision of hospice care in nursing homes has been shown to have positive effects on nonhospice residents, which suggests indirect benefits on nursing home clinical practices.
Hospice is relatively underutilized among nursing home residents at the end of life.
While most hospice care in the United States is provided in the home, the use of hospice in nursing homes has risen in recent years. This growth has coincided with increased use of hospice care more generally.
The National Hospice and Palliative Care Organization reports that more than 1.4 million Americans receive care from the nation's hospice providers annually, with 22.8% residing in a nursing home. However, only 6% of nursing home residents in the United States elect the hospice benefit, even though nearly one in four deaths in the United States occur in a nursing home.
Authors of the study found that nursing home hospice patients received the same high-quality care as those hospice patients living in their own homes.
Compared to similar residents not enrolled in hospice, previous studies reviewed by the researchers found nursing home hospice patients were more likely to be assessed for pain, twice as likely to receive daily treatment for pain, and more likely to receive pain management in accordance with clinical guidelines. They also were less likely to require hospitalization in the final 30 days of life.
The importance of communication and coordination between the hospice provider and the nursing home staff as well as the need for more education on end-of-life care among professionals was another point clearly shown in the literature reviewed.
1. Stevenson DG, Bramson JS. Hospice care in the nursing home setting: A review of the literature. J Pain Symptom Manage 2009; 38:440-451. t