Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May;34(5):580-588.
doi: 10.1177/0269216320902672. Epub 2020 Mar 10.

Palliative care and infection management at end of life in nursing homes: A descriptive survey

Aluem Tark  1 , Leah V Estrada  1 , Mary E Tresgallo  1 , Denise D Quigley  2 , Patricia W Stone  1 , Mansi Agarwal  1
Affiliations

Palliative care and infection management at end of life in nursing homes: A descriptive survey

Aluem Tark et al. Palliat Med. 2020 May.

Abstract

Background: Infections are common occurrences at end of life that are associated with high rates of morbidity and mortality among frail elderly individuals. The problem of infections in nursing homes has led to a subsequent overuse and misuse of antibiotics in this already-frail population. Improving palliative care in nursing homes has been proposed as a key strategy to reduce the use of antibiotics.

Aim: The aim of this study was to describe the current status of how nursing homes integrates palliative care and infection management at end of life across the nation.

Design: This is a cross-sectional survey of nationally representative US nursing homes.

Setting/participants: Between November 2017 and October 2018, a survey was conducted with a nationally representative random sample of nursing homes and 892 surveys were completed (49% response rate). The weighted study sample represented 15,381 nursing homes across the nation.

Results: Most nursing homes engaged in care plan documentation on what is important to residents (90.43%) and discussed spiritual needs of terminally ill residents (89.50%). In the event of aspiration pneumonia in terminally ill residents, 59.43% of nursing homes responded that resident would be transferred to the hospital. In suspected urinary tract infection among terminally ill residents, 66.62% of nursing homes responded that the resident will be treated with antibiotics.

Conclusion: The study found wide variations in nursing home palliative care practices, particularly for timing of end-of-life care discussions, and suboptimal care reported for antibiotic usage. Further education for nursing home staff on appropriate antibiotic usage and best practices to integrate infection management in palliative care at the end of life is needed.

Keywords: Health Care Survey; frail elderly; health services for the aged; hospice and palliative care nursing; infection control; nursing homes; palliative care; terminal care.

PubMed Disclaimer

Conflict of interest statement

3. Conflicts of interest

The Authors declare that there is no conflict of interest

References

    1. Centers for Medicare and Medicaid Services. Nursing Home Data Compendium 2015 Edition. 2016.
    1. Joenperä J, Van Der Zwan F, Karmel R, Cooper-Stanbury M. Long and winding road: Aged care use before death. Australasian Journal on Ageing. 2016;35(1):9–11. - PubMed
    1. Thomas T, Kuhn I, Barclay S. Inpatient transfer to a care home for end-of-life care: What are the views and experiences of patients and their relatives? A systematic review and narrative synthesis of the UK literature. Palliative medicine. 2017;31(2):102–8. - PubMed
    1. Wolrd Health Organization. Ageing and Health 2018 [updated February 5 2018 Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.
    1. Wolff JL, Starfield B, Anderson G. Prevalence, Expenditures, and Complications of Multiple Chronic Conditions in the Elderly. Archives of Internal Medicine. 2002;162(20):2269–76. - PubMed

Publication types

Substances