Patients in nursing homes are frequently transferred to the hospital for care that may not improve their condition. Better communication with families and caregivers may reduce the frequency of unneeded treatment, a new study has found.
The research, published in JAMA Internal Medicine, found that nursing homes that sent fewer patients to the hospital for end-of-life care were more likely to have serious conversations with loved ones about the potential downsides to aggressive interventions. The researchers interviewed caregivers at four nursing homes that were likely to send patients to the hospital and four that were significantly less likely to do so.
The nursing homes that avoided hospitalizations did not automatically send patients to the hospital when an acute event occurred. They also "viewed it as their role to try to change families’ minds when they requested a hospitalization that was unlikely to be beneficial,” lead study author Andrew Cohen, M.D., an assistant professor of internal medicine at Yale School of Medicine, told Reuters.
However, the researchers caution that the study is small and qualitative, so the results don’t necessarily prove one strategy is widely used or significantly impacts overall hospitalization rates.
Joan Teno, M.D., a palliative care researcher at the University of Washington who wasn’t involved in the study, advocates for advance planning to avoid unnecessary treatment at the end of life. She told Reuters that previous research shows that organizations that adopt a culture of advance care planning had lower rates of terminal hospitalizations.