The New Jewish Home, New York, New York, USA.
J Soc Work End Life Palliat Care. 2020 Jul-Sep;16(3):286-293. doi: 10.1080/15524256.2020.1800553. Epub 2020 Aug 30.
The choice to utilize hospice care in the nursing home when residents are experiencing progressive decline can promote positive quality of care and comfort for residents at the end of life. Concurrent hospice and nursing home care can be less aggressive, and improve symptom management and perceived quality by family members. Using a secondary analysis of retrospective data from the electronic medical record, this study identified predictors of hospice use among 300 nursing home decedents using a six-month look back period. Findings showed that having poorer physical status (weight loss), cognitive status, and having had a "goals of care" conversation were significantly associated with greater likelihood of using hospice in the nursing home in the last six months of life. Interdisciplinary team members who provide care on a daily basis and are in a position to detect worsening medical condition of residents and can facilitate advance planning. Care planning that includes examining goals of care and communication with hospice providers when multiple care providers are involved is essential.
当居民的病情逐渐恶化时，选择在养老院接受临终关怀，可以促进居民在生命末期的积极护理和舒适感。同时进行临终关怀和养老院护理可以减少攻击性，改善症状管理并提高家庭成员的生活质量。本研究通过对电子病历的回顾性数据分析进行二次分析，确定了在六个月的回顾期内，300 名养老院死亡者使用临终关怀的预测因素。研究结果表明，身体状况（体重减轻）、认知状况较差，以及进行过“护理目标”谈话的患者，在生命的最后六个月内更有可能在养老院中接受临终关怀。每天提供护理的多学科团队成员能够发现居民的医疗状况恶化，并可以促进预先规划。包括检查护理目标和与临终关怀提供者沟通的护理计划，在涉及多个护理提供者时是必不可少的。
