From the NHHS and NHHCS Datasets: Trends in Hospice-Palliative Care Services in Nursing Homes From 2004 to 2007

2011 ◽  
Author(s):  
Catherine A. Yeager ◽  
Leon A. Hyer ◽  
Robert C. Intrieri
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Care Services ◽  
Palliative Care Services ◽  
Hospice Palliative Care

Policy in palliative care

2015 ◽  
Author(s):  
David C. Currow ◽  
Stein Kaasa
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Health Care Providers ◽  
World Health ◽  
Care Providers ◽  
Care Services ◽  
Palliative Care Services ◽  
Organization Policy ◽  
Health Organization ◽  
Hospice Palliative Care

Hospice and palliative care services have developed in very different ways around the world. Most have been built on the momentum of visionary clinicians and funders who have responded to perceived needs from health-care providers, patients, families, and communities rather than in response to well-formed national policies with an adequately funded planning and development phase. This chapter describes the work that is being done at pan-national, national, and sub-national levels to create effective policies that can further the key work of hospice/palliative care, often after a large number of apparently unconnected local services have been well established. The chapter highlights that there are particular challenges in forming public policy on hospice/palliative care, especially the end-of-life component, and notes the importance of ‘patients’ voices’-the voice of the community which helps to inform health policies including end-of-life care. The chapter ends by describing a variety of country-specific and World Health Organization policy documents and legislation.

Is It Feasible and Desirable to Collect Voluntarily Quality and Outcome Data Nationally in Palliative Oncology Care?

2008 ◽  
Vol 26 (23) ◽  
pp. 3853-3859 ◽  
Author(s):  
David C. Currow ◽  
Kathy Eagar ◽  
Samar Aoun ◽  
Dave Fildes ◽  
Patsy Yates ◽  
...  
Keyword(s):  
Palliative Care ◽  
Primary Diagnosis ◽  
Outcome Data ◽  
Care Services ◽  
Outcomes Of Care ◽  
Unstable Phase ◽  
Symptom Scores ◽  
Palliative Care Services ◽  
Improved Function ◽  
Hospice Palliative Care

Hospice/palliative care is a critical component of cancer care. In Australia, more than 85% of people referred to specialized hospice/palliative care services (SHPCS) have a primary diagnosis of cancer, and 60% of people who die from cancer will be referred to SHPCS. The Palliative Care Outcomes Collaboration (PCOC) is an Australian initiative that allows SHPCS to collect nationally agreed-upon measures to better understand quality, safety, and outcomes of care. This article describes data (October 2006 through September 2007) from the first 22 SHPCS, with more than 100 inpatient admissions annually. Data include phase of illness, place of discharge, and, at each transition in place of care, the person's functional status, dependency, and symptom scores. Data are available for 5,395 people for 6,379 admissions. After categorizing by phase of illness and dependency, there remain at the end of each admission 12-fold differences (mean, 26%; range, 4% to 52%) in the percentage of patients who became stable after an unstable phase; seven-fold differences (mean, 22%; range, 6% to 41%) in the percentage of patients with improved symptom scores, five-fold differences (mean, 25%; range, 12% to 64%) in discharge back to the community, four-fold differences (mean, 10%; range, 4% to 16%) in improved function, and three-fold differences in the length of stay (mean, 14 days; range, 6 to 19 days). PCOC shows it is feasible to collect quality national palliative care outcome data voluntarily. Variations in outcomes justify continued enrollment of services. Benchmarking should include all patients whose cancer will cause death and explore observed variations.

Long-Term Care

2019 ◽  
pp. 606-614
Author(s):  
Joan Carpenter ◽  
Mary Ersek
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Developed Countries ◽  
The United States ◽  
Nursing Home Population ◽  
Care Services ◽  
Challenges And Opportunities ◽  
Palliative Care Services

This chapter examines palliative care across residential care settings with a focus on nursing homes. It reviews the environment of nursing homes, describes the residents who live there, and provides details about the interdisciplinary team providers who care for the residents. It also discusses the challenges and opportunities for delivering palliative care services to nursing home residents with life-limiting illness. Quality end-of-life care in nursing homes is important because more than 1.4 million Americans live in nursing homes, and more than half of these residents require extensive assistance with bathing, dressing, toileting, and mobility. Of those nursing home residents over 65 years of age, 80% are 75 years or older. Despite the efforts to keep frail elders in the community, the nursing home population is expected to increase as the numbers of older persons in the United States and other developed countries increase. The chapter concludes with a description of models for delivering palliative care in nursing homes.

scholarly journals Racial Differences in Infection Management and Palliative Care at End-of-Life in Nursing Homes Nationwide

2021 ◽  
Vol 1 (S1) ◽  
pp. s69-s69
Author(s):  
Leah Estrada ◽  
Andrew Dick ◽  
Patricia Stone ◽  
Jordan Harrison
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
Nursing Home Residents ◽  
County Level ◽  
Infection Management ◽  
Care Services ◽  
Black Residents ◽  
Palliative Care Services

Background: Infections are common at end-of-life in older nursing-home residents. This often leads to the overuse of antibiotics and burdensome treatments. Improving infection management through palliative care at the end of life has been proposed as a key strategy to reducing inappropriate antibiotic use. Black nursing-home residents tend to reside in poorly performing nursing homes. We examined palliative care services in nursing homes with varying proportions of black residents. Methods: Cross-sectional, nationally representative nursing-home survey data (2017–2018) was combined with the Minimum Data Set 3.0 (nursing-home resident characteristics), the Certification and Survey Provider Enhanced Reporting data (nursing-home facility characteristics), and the Multidimensional Deprivation Index (county-level poverty estimates). The survey included 24 validated items on nursing-home palliative care services, as well as the nursing home’s infection control program and integration of infection management and palliative care (summative score, 0–100). We used nursing-home facility-level multivariate regression to estimate the relationship between proportion of black residents and palliative care scores, before and after controlling for county-level poverty estimates, facility characteristics, and resident characteristics. We categorized proportion of black residents using methods reported in the literature (25%). Results: The mean weighted palliative-care score in our sample of 869 nursing homes (weighted n = 15,020) was 47.7 (SE, 0.70). In unadjusted analyses, nursing homes with higher proportions of black residents provided significantly fewer palliative care services than nursing homes with no black residents, with the greatest differences (P = .027) observed between nursing homes with >25% black residents (mean palliative care score, 43.82; SE, 2.31) versus nursing homes with no black residents (mean palliative care score, 49.47; SE, 1.08). These disparities persisted after adjustment for urbanicity and county-level poverty rates (p < 0.01) but were attenuated after further adjustment for resident and facility level characteristics (p=0.138). Conclusions: Our findings demonstrate that wide variations in nursing-home palliative-care services exist with increased proportions of black residents, even after accounting for community characteristics. Further research is needed to identify and understand the specific community characteristics that play a role in the provision of palliative care services. Palliative care is a method to reduce inappropriate antimicrobial use at the end of life and should be expanded with a focus on nursing homes with higher proportions of black residents.Funding: NoDisclosures: None

Palliative Care Services in Pennsylvania Nursing Homes

2006 ◽  
Vol 9 (5) ◽  
pp. 1054-1058 ◽  
Author(s):  
Nancy Hodgson ◽  
Lisa Landsberg ◽  
Amanda Lehning ◽  
Mort Kleban
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Care Services ◽  
Palliative Care Services
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