Variations in patterns of care activities for nursing home residents with heart failure

Early clues of change in heart failure (HF) status, such as weight gain or reduced exercise tolerance, may be missed by caregivers in nursing homes (NHs) since daily weight measurement and functional assessments may not be performed routinely. These factors are likely to contribute to a delay in non-emergent care for the resident. The purpose of this study was to examine patterns of care activities provided in the NH setting to residents with HF and document variations in these care patterns across a random national sample of NHs. Care activities performed daily within a large proportion of NHs for residents with HF were assessment for changes in HF symptoms (94%), changes in mental status (91%), and changes in swelling/edema (85%). There was wide variation in care patterns. Not all evidence-based guidelines for HF care and monitoring were followed in the NH setting, which could affect hospitalizations and other outcomes.