Do Nursing Home Residents Get the Palliative Care they Deserve?

Nov 30, 2017

A recent U.S.  study has many people asking – “do nursing home residents get the palliative care they deserve?” It seems that many nursing home residents who are eligible for palliative care, or who could benefit from it, do not receive it in the way they should.  Let’s take a closer look at what research has to say and explore palliative care and the legal rights of nursing home residents.

Research Suggests Nursing Home Residents Do Not Get Adequate Palliative Care

Researchers recently conducted a study of 228 residents living across three northern California nursing homes.  Researchers discovered that 157 of the 228 residents (69 percent) were eligible for palliative care based on their health issues.  Of those, none were receiving palliative care, and only two were receiving hospice services.  Only four percent of the residents studied had been assessed by the nursing home to determine prognosis and life expectancy based on their diagnoses.

Among the nursing home residents studied in this research, around 25 percent of patients surveyed expressed a desire for “comfort-focused treatment” as end-of-life care.  Some 71 percent of patients reported experiencing bothersome symptoms.  Around 64 percent of family members reported belief that their loved ones experienced bothersome symptoms.

Why Palliative Care is Important

It is widely accepted that palliative care is initiated too late in the healthcare process for nursing home residents to get the real benefits of what palliative care is designed to offer.  When implemented in a timely and effective manner, palliative care offers improved quality of life, enhanced symptom management, and increased satisfaction with overall care.  These benefits are for the patient and his or her family during a difficult time.

Palliative care is often confused with hospice care, and while similar, they offer different levels of care.  Palliative care is used to improve quality of life for individuals who are seriously ill.  Palliative care focuses not only on comfort and pain relief, but also stress management that coincides with ongoing treatment to cure the disease.  Hospice, on the other hand, focuses on comfort and pain relief without offering active treatment.

The Larger Scale Concern for Nursing Homes

This recent study was small-scale, and only offers a glimpse at what may be a larger problem.  Researchers noted in JAMA Internal Medicine that by the year 2030, two of every five deaths in the U.S.  will occur in nursing homes.  Unfortunately, nursing homes continue to be associated with poor quality and low resident satisfaction levels.  Despite costing an estimated $136 billion per year, nursing homes still fail to provide residents with the quality of care needed.

Nursing homes across the U.S.  can take this research as an important element of addressing the larger problem.  Assessment, treatment, comfort, and pain relief are all fundamental rights of nursing home residents, regardless of how that care is labeled.  It is the duty of the nursing home to address the needs of residents and pursue resources to ensure that quality care is provided.

What Families Can do to Protect Safety and Comfort

One of the best ways to ensure that your loved one gets the quality of care that he or she deserves is being proactive when choosing a nursing home.  No matter what the diagnosis or life expectancy is, your loved one has the right to receive quality, safe, effective care.  Consider the following tips before choosing a nursing home:

  • Ask if the nursing home has a contract for hospice or palliative care services.
  • Ask who provides these services (nurse, pharmacist, social worker, dietician, etc.).
  • Ask if you can schedule a consultation for these services.
  • Ask what palliative care has to offer that is different from routine doctor care.

If your loved one is already living in a nursing home, remember these tips:

  • Any concerns about symptom management should be addresses with nursing staff. If issues continue, contact a nursing home Ombudsman or licensing authority.
  • Remember that palliative care is designed to provide care and comfort for the whole person, just not one part of the body that is sick. With palliative care, your loved one should receive whole person-centered attention and care.
  • If at any time you feel that your loved one is not getting the level of care needed, contact your loved one’s doctor and nursing home administrators

Remember that there are many misconceptions about palliative care and hospice.  For example, it is not true that once an individual is placed on hospice he or she must remain on hospice until death.  Hospice is a choice, and an individual (or his or her power of attorney) may choose to initiate or cancel hospice.

It is also not true that choosing to initiate palliative care is the same thing as “giving up”.  Many people choose to initiate palliative care while they are undergoing treatment for serious illnesses.  Palliative care can help alleviate bothersome symptoms and keep the patient comfortable and stable while treatment focuses on reversal or a cure.

Protecting the Legal Rights of Nursing Home Residents

When you are concerned about the safety or quality of care your loved one is receiving, you may be unsure of where to turn.  Many families find it helpful to contact a nursing home abuse attorney to learn more about the legal rights of nursing home residents.  Nursing home abuse attorneys also have many resources that can help ensure that your concerns are not overlooked or ignored.

At Brown & Brothers, we strive to offer our clients and their families with competent, compassionate legal guidance.  If you have concerns about palliative care, or the fact that your loved one is not receiving adequate care, fill out our online form to schedule a consultation with one of our skilled attorneys.