Caring About Residents' Experiences and Symptoms (CARES) Program: A Model of Palliative Care Consultation in the Nursing Home

被引：11
作者：
Morris, Deborah A. [1 ]
Galicia-Castillo, Marissa [1 ]
机构：
[1] Eastern Virginia Med Sch, Glennan Ctr Geriatr & Gerontol, Dept Internal Med, 825 Fairfax Ave Suite 201, Norfolk, VA 23507 USA
来源：
AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE | 2017年 / 34卷 / 05期
关键词：
nursing home; palliative care; long-term care; SNF; models of care; geriatrics; MEDICAL DIRECTORS; HOSPITALIZATION; QUALITY; PREDICTORS; TRANSFERS; FACILITY;
D O I：
10.1177/1049909116641606
中图分类号：
R19 [保健组织与事业（卫生事业管理）];
学科分类号：
摘要：
Objectives: To describe the CARES program, a model of palliative care for nursing home residents. Design: Descriptive analysis of the Caring About Residents' Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents. Program evaluation: The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred. Results: 170 nursing home residents were seen by CARES Program between February 2013 to December 2015, 48% for skilled services, and 52% for long term care. Majority of referrals were for goals of care and concurrent symptom management. Following consultation, 67% of residents had a change in code status. Of residents desiring a palliative course 90% were never hospitalized. Overall, 53% of residents died; and those in long term care dying more often with hospice. Conclusion: The CARES program of palliative consultation addresses the needs of nursing home residents. The model has potential to be reproducible in in other communities.
引用
收藏
页码：466 / 469
页数：4
相关论文
共 14 条
[1]  
[Anonymous], 2007, IMPROVING PALLIATIVE
[2]   Nursing home capabilities and decisions to hospitalize: A survey of medical directors and directors of nursing [J].
Buchanan, JL ;
Murkofsky, RL ;
O'Malley, AJ ;
Karon, SL ;
Zimmerman, D ;
Caudry, DJ ;
Marcantonio, ER .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2006, 54 (03) :458-465
[3]   Variations in hospitalization rates among nursing home residents: The role of facility and market attributes [J].
Carter, MW ;
Porell, FW .
GERONTOLOGIST, 2003, 43 (02) :175-191
[4]   Predictors of nursing home hospitalization - A review of the literature [J].
Grabowski, David C. ;
Stewart, Kate A. ;
Broderick, Suzanne M. ;
Coots, Laura A. .
MEDICAL CARE RESEARCH AND REVIEW, 2008, 65 (01) :3-39
[5]   Raising The Standard: Palliative Care In Nursing Homes [J].
Meier, Diane E. ;
Lim, Betty ;
Carlson, Melissa D. A. .
HEALTH AFFAIRS, 2010, 29 (01) :136-140
[6]   Advanced Dementia: State of the Art and Priorities for the Next Decade [J].
Mitchell, Susan L. ;
Black, Betty S. ;
Ersek, Mary ;
Hanson, Laura C. ;
Miller, Susan C. ;
Sachs, Greg A. ;
Teno, Joan M. ;
Morrison, R. Sean .
ANNALS OF INTERNAL MEDICINE, 2012, 156 (01) :45-U95
[7]   Predictors of Nursing Home Residents' Time to Hospitalization [J].
O'Malley, A. James ;
Caudry, Daryl J. ;
Grabowski, David C. .
HEALTH SERVICES RESEARCH, 2011, 46 (01) :82-104
[8]   The Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program: An Overview for Medical Directors and Primary Care Clinicians in Long Term Care [J].
Ouslander, Joseph G. ;
Bonner, Alice ;
Herndon, Laurie ;
Shutes, Jill .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2014, 15 (03) :162-170
[9]   Reducing Unnecessary Hospitalizations of Nursing Home Residents [J].
Ouslander, Joseph G. ;
Berenson, Robert A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (13) :1165-1167
[10]   Integrating Palliative Care in the Nursing Home: An Interprofessional Opportunity [J].
Swagerty, Daniel .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2014, 15 (12) :863-865
12