Journal of the American Medical Directors Association
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To explore next-of-kin's (NOK's) perceptions of end-of-life (EOL) care in the nursing home setting and to compare these perceptions for residents receiving hospice care plus usual care versus usual care only. ⋯ In this pilot study, NOK perceived that decedents' EOL care in the nursing home was of similarly good quality under hospice care plus usual care and usual care only. Our study provides an approach to assessing quality of EOL care in the nursing home setting.
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The objective of this study was to describe antihypertensive medication use, determine what effects comorbid illness has on prescribing of commonly used antihypertensive medications, and explore how treatment affected selected clinical and functional outcomes in US nursing home residents. ⋯ Hypertension is prevalent in US nursing home residents and most residents with that diagnosis (84%) are being treated with antihypertensive medication. Through examination of the National Nursing Home Survey database, associations between the use of selected antihypertensive medication, comorbid illness, and specified outcomes were observed.
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Elders' predilections regarding end-of-life interventions vary with their living environs. ⋯ Elders residing in nursing homes were more likely than ambulatory patients to request invasive end-of-life care, a difference that was more pronounced when outcome required disposition to an SNF. These preferences were not dependent on patients' self-described disability or quality of life. This study suggests that qualitative outcomes matter to patients and their choices are associated with their place of residence.
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The purpose of this study was to evaluate the effects of small-scale living facilities in dementia care on residents, family caregivers, and staff. ⋯ This study was unable to demonstrate convincing overall effects of small-scale living facilities. Because governmental policies and, in some countries, financial support, are increasingly aimed at providing small-scale, homelike care, it is suggested that this may not be a final solution to accomplish high-quality dementia care and that other options should be considered.
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The objectives of this study were to determine the prevalence of pain, describe its treatment, and determine factors associated with any pain in older residents assigned to a hospice specialty unit bed or receiving services from a hospice/palliative care/end-of-life special program in US nursing homes. ⋯ Pain symptoms were present in more than one third of older nursing home hospice/palliative care residents despite the use of opioids in two thirds of those who had reported or shown evidence of any pain. Additional future studies are needed to improve the management of pain in older residents receiving hospice/palliative care in US nursing homes.