Perceptions of Family Decision-makers of Nursing Home Residents With Advanced Dementia Regarding the Quality of Communication Around End-of-Life Care.
Mark Toles, Mi-Kyung Song, Feng-Chang Lin and 1 others
PMID 30032997WHAT IT FOUND
Family decision-makers rated nursing home staff communication better than clinician communication, but many reported staff and clinicians omitted end-of-life topics such as how long the resident has to live and what dying might be like.
Key findings
01On a 0-to-10 scale, families rated overall communication with nursing home staff 5.5 and with clinicians 3.7.
02Most families said clinicians did not do six of seven end-of-life communication items, including talking about how long the resident has to live (83.1% omitted) and what dying might be like (88.4% omitted).
03At least half of families said nursing home staff did not do five of seven end-of-life items, including talking about feelings about the resident getting sicker (57.9% omitted) and details if the resident got sicker (62.9% omitted).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
All nursing homes were in North Carolina, so the findings may not apply to other regions. Families reported what they remembered, and some information may have been given to another family member or not absorbed. The categories nursing home staff and clinicians combined nurses with social workers, and physicians with advanced practice clinicians, so discipline-specific differences may be hidden. This analysis described baseline perceptions and did not test the decision aid intervention. Only 20% of enrolled residents died during the following 9 months, so clinicians may have felt end-of-life discussions were premature for some families.
Declared interests
The paper reports NIH extramural research support. The conflict-of-interest table lists financial and personal relationship disclosures for authors MT, MKS, FCL and LCH, but the supplied text does not clearly identify the source, amount, or which specific disclosures apply.
The easy way to misread this
Do not treat the low scores as proof that staff and clinicians never discussed end-of-life care. The study measured family-reported perception, and some information may have been given to another family member or not absorbed.