Global brain failure in a nursing home resident population

Data from a Minneapolis Professional Standards Review Organization (PSRO) are used to explore the frequency of global brain failure, a group of diseases, in a population of nursing home residents. Findings are related to three other studies of the same or similar phenomena. Approximately 15 per cent of all patients in the Minnesota database exhibit global brain failure as measured by functional impairment on mental and physical indices. Thirty per cent of the patients in the database are incontinent. These findings raise ethical issues concerning the care management of the global brain failure patient who has an irreversible and gradually fatal disease.