Dementia Patients Face Needless Transitions in Last 90 Days of Life

This study finds such transitions are not consistent with goals of providing dying patients with comfort.By Alzheimer's Reading RoomA study in theNew England Journal of Medicine reports thatnearly one in five nursing home residents with advanced dementia experiences burdensome transitions in the last 90 days of life.This includes moving to a different facility in the last three days of life or repeat hospitalizations for expected complications of dementia in the last 90 days of life."Ultimately, all of these problems are signs of care gone awry.The best care for a patient with advanced cognitive impairment near the end of life is often to maximize comfort. The burdens of hospitalization usually outweigh the benefits -- Joan Teno."Subscribe to the Alzheimer's Reading RoomEmail:“Such patterns of transitions are burdensome, particularly sincethe overwhelming majority of family members state the main goal of care is comfort, ” said study co-author Joan Teno, professor of health policy and practice at theAlpert Medical School of Brown University and a palliative care physician.“These transitions reflect the inefficiency of our health care system. Similar outcomes could be achieved by keeping these patients in the nursing home setting."An important reason for the prevalence of burdensome transitions might be embedded in the wayMedicare pays nursing homes, said Brown health economist and lead author Pedro Gozalo.Nursing homes can earn higher payments for patients who have been...
Source: Alzheimer's Reading Room, The - Category: Neurology Tags: aging alzheimers care alzheimers information dementia elder care health medical science nursing home palliative care Source Type: blogs