End-of-life care in U.S. nursing homes: a review of the evidence
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Debra Parker Oliver1, Davina Porock, Steven Zweig
1School of Social Work, Sinclair School of Nursing, University of Missouri-Columbia, 719 Clark, Columbia, MO 65212, USA. oliverdr@missouri.edu
Objectives:
The purpose of this study was to systematically review the empiric evidence on end-of-life care in nursing homes in the United States The guiding research question for this review was what is the state of research evidence in end-of-life care in long-term care?
Design:
We conducted a systematic review of the literature.
Data:
The review was limited to published and indexed research in peer-reviewed journals in five major databases between 1995 and October 2002.
Results:
The initial search yielded a total of 395 articles. The search was narrowed, focusing on nursing homes in the United States and empiric research. The result was 43 articles related to research in end-of-life care in American nursing homes. It was categorized into eight foci: prognosis, pain, hospice, hospitalization, advanced care planning, communication, family perceptions, and miscellaneous.
Conclusion:
There is a dearth of research published in end-of-life care in the nursing home setting. What is available is primarily descriptive. The empiric research only documents poor end-of-life care in U.S. nursing homes. Empiric evidence has grown in this area, but there is now a need for research of creative and innovative solutions aimed at improving the quality of end-of-life care in this setting.
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