Caring for nursing home patients--a primary care perspective.

Older people in nursing homes constitute a vulnerable population with complex medical and mental health issues. They are predicted to make up an increasing proportion of our communities. In Ireland the majority of long term residents are in private-sector nursing homes. Their medical care needs are the responsibility of general practitioners (GPs). This study aims to identify current practice and major challenges facing GPs and highlight their contractual, educational and specialist support needs to care for this vulnerable group of patients. Survey of 476 general practitioners in the greater Dublin city area; 186 (39%) replied. 54% of respondents believed nursing home patients (NHP's) required more contact time than other practice patients. 62% regularly reviewed repeat prescriptions. Only 60% felt they had adequate geriatric medical training to look after this population. 37% had witnessed substandard care in nursing homes and of these 26% did not report it. 53% of those that did report it did so to the management of the nursing home only.