Rehabilitation Therapy for Nursing Home Residents at the End-of-Life.
Helena Temkin-Greener, Tiffany Lee, Thomas Caprio and 1 others
PMID 30287262WHAT IT FOUND
Therapy for nursing home residents in their last month of life became more common and more intense, with much of it delivered very close to death.
The study cannot tell you whether physical, occupational, or speech therapy helped or harmed.
Key findings
01The share of residents who received any physical therapy, occupational therapy, or speech therapy in the last 30 days of life rose from 11.6% to 14% across years 1 through 3 and was 13.3% in the partial year 4.
02Most physical therapy, occupational therapy, and speech therapy in the last month of life occurred close to death: 48% in the last 7 days and almost 70% in the 14 days before death.
03Residents in for-profit facilities had an 18% higher risk of low-to-medium combined physical, occupational, and speech therapy and more than 2-fold higher risk of high-to-ultrahigh combined therapy compared with no therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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
The study used records from New York nursing homes only, so results may not apply to other states or health systems. It used administrative MDS data, so it could not tell whether therapy was beneficial or harmful to residents. Physical therapy, occupational therapy, and speech therapy were combined in the main results, so the contribution of any single therapy type cannot be separated. The study did not measure resident goals, symptoms, quality of life, or whether therapy fit the clinical situation near death. Facility factors such as for-profit status and physical therapist availability are associations, not proof that those factors caused higher therapy use.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the rise in therapy as proof that therapy is helpful at the end of life. The study combined physical therapy, occupational therapy, and speech therapy minutes, and it did not measure whether therapy helped or harmed residents.