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Care in Nursing Facilities after Palliative Consult.
Joan G Carpenter1, Patricia H Berry2, Mary Ersek3
1Post-doctoral Nurse Research Fellow, Patient Care Services/Department of Nursing, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia.
Summary
Older adults often experience a gap in care after hospital palliative care consultations. This discontinuity, marked by poor communication and mismatched goals, negatively impacts their transition to nursing home settings.
Area of Science:
- Gerontology
- Palliative Care
- Health Services Research
Background:
- Hospital palliative care consultations address goals of care for patients with poor prognoses.
- Older adults are frequently admitted to nursing homes for post-acute rehabilitation following hospitalization.
Purpose of the Study:
- To describe factors influencing care discontinuity between palliative care consultations and subsequent nursing home care.
- To explore the consequences of this care discontinuity for older adults.
Main Methods:
- Qualitative descriptive study involving 12 older adults (mean age 80 years).
- Data collection included semi-structured interviews and medical record reviews.
- Inductive content analysis was used for data analysis.
Main Results:
- Two primary themes emerged: Inadequate Communication and Prognosis Incongruence.
- Inadequate Communication: Lack of information transfer regarding palliative care consults post-discharge.
- Prognosis Incongruence: Discrepancy between hospital prognosis and nursing home care focus.
Conclusions:
- Significant communication gaps exist between hospital palliative care and nursing home settings.
- Re-addressing goals of care, prognosis, and symptoms is lacking during transitions.
- Improved palliative care delivery during post-hospitalization and nursing home transitions is essential.
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