End-of-Life Care in Nursing Homes with Greater versus Less Palliative Care Knowledge and Practice

Journal of Palliative Medicine
Susan C MillerSarah A Thompson

Abstract

Many older adults in nursing homes (NHs) lack palliative care (PC) access; but little is known about whether access to PC knowledge and practice (beyond hospice) impacts residents' care. The study objective was to evaluate how differing levels of NH PC knowledge and practice are associated with residents' end-of-life health care use. In 2009/10 we surveyed a stratified random sample of U.S. NHs and asked directors of nursing (DONs) PC knowledge and practice questions from Thompson and colleagues' validated PC Survey. This study includes 1981 NHs with complete survey responses and the 58,876 residents who died in these facilities between July 2009 and June 2010. Medicare resident assessment (minimum data set [MDS]) and claims data from July 2009 through June 2010 were used to determine outcomes and a NH's hospice use. Multivariate logistic regressions examined whether residing in NHs with higher PC scores was associated with documented six-month prognoses and receipt of aggressive treatments, including hospital and emergency room (ER) use in the last 30 days of life. Controlling for NH hospice use, being in a NH with higher PC care knowledge scores was associated with residents having a higher likelihood of documented six-month ...Continue Reading

References

Apr 12, 2002·Journal of the American Geriatrics Society·Susan C MillerKate Lapane
Sep 12, 2003·Journal of Pain and Symptom Management·Susan C MillerJoan Teno
Jan 8, 2004·JAMA : the Journal of the American Medical Association·Joan M TenoVincent Mor
May 14, 2005·Journal of the American Medical Directors Association·Debra Parker OliverSteven Zweig
Jul 5, 2005·Journal of Palliative Medicine·Laura C HansonC Glenn Pickard
Feb 10, 2006·JAMA : the Journal of the American Medical Association·Laura C Hanson, Mary Ersek
Mar 23, 2006·Journal of the American Geriatrics Society·Jean C MunnC Madeline Mitchell
Mar 17, 2007·Health Services Research·Pedro L Gozalo, Susan C Miller
Jan 24, 2008·Health Services Research·Pedro L GozaloVincent Mor
Jul 4, 2009·The Gerontologist·Helena Temkin-GreenerPeter Veazie
Jan 6, 2010·Health Affairs·Diane E MeierMelissa D A Carlson
Jul 22, 2010·Journal of the American Geriatrics Society·Susan C MillerVincent Mor
Aug 20, 2010·Journal of Pain & Palliative Care Pharmacotherapy·UNKNOWN Medicare Payment Advisory Commission U.S. Department Of Health And Human Services
Aug 28, 2010·Journal of Pain and Symptom Management·Sarah ThompsonVirginia P Tilden
Sep 8, 2010·Journal of the American Medical Directors Association·Nan Tracy Zheng, Helena Temkin-Greener
Sep 8, 2010·The New England Journal of Medicine·Jennifer S TemelThomas J Lynch
Nov 17, 2010·The Gerontologist·Denise A TylerMelissa A Clark
Jan 27, 2011·Journal of the American Medical Directors Association·Melissa D A CarlsonDiane E Meier
May 17, 2011·Journal of Translational Medicine·James M BalwitFrancesco M Marincola
Dec 12, 2012·The Gerontologist·Jody ComartJohn N Morris

❮ Previous
Next ❯

Citations

Jul 8, 2015·Journal of Pain and Symptom Management·Kathleen T UnroeSusan C Miller
Dec 17, 2014·Journal of Pain and Symptom Management·Denise A TylerSusan C Miller
Aug 17, 2016·Journal of Palliative Medicine·Helena Temkin-GreenerDana B Mukamel
Jan 9, 2018·The Gerontologist·Sally A NortonHelena Temkin-Greener
Aug 18, 2017·Journal of Palliative Medicine·Julie C Lima, Susan C Miller
Nov 28, 2018·European Journal of Public Health·Anna E BoneIrene J Higginson
Aug 2, 2019·Palliative Medicine·Katharina AllersRieke Schnakenberg
Apr 17, 2018·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Joan G CarpenterMary Ersek
Jul 28, 2020·International Journal of Environmental Research and Public Health·Eliza Lai-Yi WongEng-Kiong Yeoh
Apr 26, 2016·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Samantha Johnson, Marjorie J Bott
Dec 29, 2019·BMC Palliative Care·Franco ToscaniPaola Di Giulio
Mar 23, 2021·Journal of the American Geriatrics Society·Helena Temkin-GreenerShubing Cai
Jan 12, 2020·Journal of the American Medical Directors Association·Joan G CarpenterMary Ersek

❮ Previous
Next ❯

Methods Mentioned

BETA
MDS

Software Mentioned

Stata
MDS

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.