Dying is universal, but what
about differences and similarities in end-of-life (EOL) care? Most of my
nursing home experiences with hospice care have been in an urban area. I was
curious about this University of Rochester, NY research that compared rural and urban end-of-life care in nursing homes.
The purpose of this study by
the University of Rochester, NY was to examine urban-rural differences in
end-of-life quality of care provided to nursing home residents. A national
sample of nursing homes was used. Three measured areas of focus were
in-hospital death, hospice referral before death, and presence of severe pain.
Research results indicated
there were urban-rural differences for in-hospital death and hospice quality
measures, but not for pain. Compared with nursing homes located in urban areas,
facilities in smaller towns and in isolated rural areas had significantly worse
EOL quality for in-hospital death and hospice use. Differences were not
statistically significant between facilities located in small towns and isolated
rural areas.
According to the report, this
study provides “empirical evidence for urban-rural differences in EOL quality
of care using a national sample of nursing homes.” This research data is
important because it serves as a necessary first step toward improving EOL care
for dying nursing home residents and for bridging the urban-rural gap.
This video titled End
of Life: Burdensome Transitions from Brown University refers to another EOL study that
addresses health care
transitions such as moves from the nursing home to the hospital. These
burdensome transitions can result in medical errors and lack of care
coordination. For persons with advanced dementia, they can cause emotional
distress and agitation. According to this study, such transitions are not
consistent with goals of providing dying patients with comfort, and a fifth of
them experience at least one during their last three months. African Americans and Hispanics were
more likely than whites to experience these burdensome transitions.
Frances Shani Parker,
Author
Becoming Dead Right: A
Hospice Volunteer in Urban Nursing Homes
is available in paperback at many booksellers and in e-book form at
Amazon and Barnes and Noble booksellers.
This is really quite an informative and also very touching blogpost in regards to nursing homes of old age this is a social awareness cause and would do my very best for this...
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