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Rehabbed to Death: Breaking the Cycle.

Lynn A Flint1,2, Daniel David3, Joanne Lynn4

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Many older adults cycle between hospitals and post-acute care (PAC) facilities, a trend termed "rehabbing to death." This highlights systemic failures in geriatric care, necessitating policy and practice reforms for better end-of-life support.

Keywords:
goals of carehospitalnursing homepost-acute careskilled nursing facility

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Area of Science:

  • Gerontology
  • Healthcare Policy
  • Palliative Care

Background:

  • Older adults frequently transition between hospital and post-acute care (PAC) settings during their final life phase.
  • The current healthcare system often fails to meet the complex needs of older adults and their families at the end of life.
  • Misnomers like referring to PAC facilities as 'rehab' obscure the true nature of care provided.

Purpose of the Study:

  • To advocate for critical practice and policy changes in geriatric care.
  • To address the phenomenon of older adults undergoing repeated hospitalizations and PAC stays in their final phase of life.
  • To improve alignment between healthcare policies and the needs of older adults and their caregivers.

Main Methods:

  • Proposing a shift in terminology from 'rehab' to 'after-hospital transitional care' for PAC facilities.
  • Recommending the adoption of serious illness communication strategies for end-of-life care discussions.
  • Advocating for policies that promote comprehensive care planning and caregiver support.

Main Results:

  • Implementing proposed changes can reduce the cycle of hospital-PAC-hospital transfers for older adults.
  • Realigning policies can ensure care aligns with patient preferences and priorities.
  • Improved communication and care planning can lead to better end-of-life experiences.

Conclusions:

  • The current healthcare system's approach to post-acute care for older adults requires significant reform.
  • Adopting person-centered language and communication models is crucial for improving geriatric end-of-life care.
  • Policy changes incentivizing comprehensive planning and caregiver support are essential for dignified aging and dying.