Mount Sinai School of Medicine, New York City, USA.
Health Aff (Millwood). 2010 Jan-Feb;29(1):136-40. doi: 10.1377/hlthaff.2009.0912.
More than two-thirds of long-stay nursing home residents suffer from dementia. This illness has a variable and unpredictable course that renders it a poor fit for the six-month life-expectancy requirement of the Medicare hospice benefit. Palliative care-a form of treatment that strives to match care to patient goals, relieve pain, and improve quality of life for people with chronic or life-threatening illnesses-should be the standard of practice for all elderly dementia patients in nursing homes, regardless of prognosis. Similar principles could apply to other long-term residents with underlying chronic diseases who would benefit from palliative care. Indeed, we would argue that the growing acceptance of the culture-change movement centered on elder-directed goals in nursing homes is promising evidence of the goodness-of-fit of palliative care principles in the long-term care setting.
超过三分之二的长期疗养院居民患有痴呆症。这种疾病的病程多变且难以预测，因此不符合医疗保险临终关怀福利的六个月预期寿命要求。姑息治疗是一种治疗方式，旨在根据患者的目标调整护理，减轻疼痛，提高患有慢性或危及生命疾病的人的生活质量，无论预后如何，都应成为疗养院中所有老年痴呆症患者的标准治疗方法。类似的原则也适用于其他患有潜在慢性疾病的长期居民，他们将从姑息治疗中受益。事实上，我们可以说，以疗养院中以老年人为导向的目标为中心的文化变革运动日益被接受，这是姑息治疗原则在长期护理环境中适应性良好的有希望的证据。
