Care in Nursing Facilities after Palliative Consult.
Joan G Carpenter, Patricia H Berry, Mary Ersek
PMID 29657556WHAT IT FOUND
Hospital palliative care goals were often missing when 12 patients entered nursing homes.
Families expected improvement, and therapy was ordered despite poor prognosis.
Key findings
01Palliative care consult details were rarely transferred to the nursing home: the note was in only 3 of 12 records, and discharge summaries did not explain its content.
02The hospital palliative team documented a poor prognosis for 11 patients, but nursing home admission notes did so for only 1.
03All 12 patients were admitted under the skilled nursing facility benefit, which included therapy, and the rehabilitation focus did not match the poor prognosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Only 12 patients were studied at one hospital and one nursing home, so this describes a small group and not all nursing home transitions. Nursing staff were not interviewed or observed, so informal handoff conversations may have occurred but were not captured. The study relied on medical records, so care that happened but was not documented could be missing. Patients were English speaking, aged 60 and older, and excluded if already enrolled in hospice, so the findings may not apply to other patients.
The easy way to misread this
Do not read this as proof that palliative care consults fail or that therapy should be withheld. It describes 12 cases at one nursing home where consult information was often missing and prognosis views differed, and it did not test an intervention.