More than 1.5 million adults live in nursing homes in the United States, and approximately 30 percent of people will die with a nursing home as their last place of residence. As this population continues to increase, so will the need for physicians to assist those patients with proper care and guidance in making end-of-life decisions.
The role of physicians in collaborating with a team of caregivers and family members in nursing home care is the focus of an article by MU researchers that appears in the Journal of the American Medical Association. Recommendations in the article provide a guide for physicians to follow when considering a patient’s admission to a nursing home, assessing health and care while in the nursing home, and advising end-of-life care.
“Part of the physician’s role is determining the risk factors for going into a nursing home,” said Dr. Steven Zweig, chair of family and community medicine and lead author of the article. “Looking at the developmental tasks and stages that patients and family members go through in assessing long-term care and providing recommendations for care was our focus.”
Zweig and his colleagues — Lori Popejoy, assistant professor in the Sinclair School of Nursing, and Debra Parker-Oliver and Susan Meadows, both with the family and community medicine department — describe a three-step communication process to assist physicians in better dialogue with patients and family members as they determine goals for care. Each step contains examples of questions to ask patients and suggested discussion topics, ranging from talking about the patient’s values, social support system and medical decisions to guidelines for adopting a living will.