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Medline ® Abstract for Reference 93

of 'Benefits, services, and models of subspecialty palliative care'

Raising the standard: palliative care in nursing homes.
Meier DE, Lim B, Carlson MD
Health Aff (Millwood). 2010 Jan-Feb;29(1):136-40.
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.
Mount Sinai School of Medicine, New York City, USA. diane.meier@mssm.edu