Long-term care organizational challenges and strategies art vs. regulation

1. Long-term residents of nursing homes, especially those with chronic deteriorating illnesses, may be at risk of overly rigorous treatment or abandonment because they do not fit the typical rehabilitative or terminal care planning models. 2. A proactive approach to care planning once rehabilitation is no longer an option emphasizes ongoing dialogue with the resident and family to determine their values and wishes for care, not merely determining the treatments they want withheld. 3. Although staff are enthusiastic about proactive, individualized, interdisciplinary planning for the care of residents, in actuality it is extremely difficult given current organizational constraints.