Care in Nursing Facilities after Palliative Consult

Joan G. Carpenter, Patricia H. Berry, Mary Ersek

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Despite hospital palliative care consultations during which goals of care are discussed in the context of poor prognoses, older adults are admitted to nursing homes (NHs) for post-acute care where the focus is on rehabilitation. The purpose of this qualitative descriptive study was to describe factors that influence discontinuity between a palliative care consult and NH care and explore the potential consequences of this discontinuity. Twelve adults (mean age, 80 years) were enrolled from 1 community hospital and NH in the mid-Atlantic United States. Semistructured interviews and medical record reviews were used to elicit information about clinical course, care processes, and patient/family preferences at hospital discharge and up to 4 times after NH admission. Data were analyzed using inductive content analysis techniques. Analysis revealed 2 themes: inadequate communication, characterized by the lack of information about the palliative care consult after hospital discharge, and prognosis incongruence, evidenced by data demonstrating a discrepancy between hospital prognosis and NH care. Ongoing communication between settings to readdress goals of care, prognosis, and symptoms - the central tenets of palliative care - is lacking. Efforts to improve access to comprehensive palliative care delivery after hospitalization and during NH transitions are greatly needed.

    Original languageEnglish (US)
    Pages (from-to)153-159
    Number of pages7
    JournalJournal of Hospice and Palliative Nursing
    Volume20
    Issue number2
    DOIs
    StatePublished - Apr 1 2018

    Keywords

    • continuity of patient care
    • hospitalization
    • nursing homes
    • palliative care
    • post-acute care

    ASJC Scopus subject areas

    • Community and Home Care
    • Advanced and Specialized Nursing

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