Palliative care may mean fewer difficult transitions for older adults nearing end of life
Palliative care is treatment—such as medication, nutritional support, or massage—that helps you feel better when you have a serious illness. Palliative care can help ease pain, insomnia, shortness of breath, nausea, and appetite loss. Other forms of this care, such as counseling, also can help older adults and their families cope with the emotional, social, practical, and spiritual challenges that may arise during a serious illness.
A team of researchers decided to examine whether palliative care could make life easier for older adults with serious illnesses who live in nursing homes, especially as they neared the end of their lives. The team studied the connection between palliative care treatment and very ill nursing home residents' need for emergency services or hospital admissions. The researchers published their findings in the Journal of the American Geriatrics Society.
The researcher team wanted to identify and study nursing home residents who had received palliative care during the six months prior to their death. To do so, they merged Medicare data with data from assessments of nursing home residents and palliative care provider visits from 2006 to 2010. The researchers considered the residents' birth dates, gender, health issues, and dates of first palliative care consultation. They also studied whether the residents were seen in emergency rooms during the last 30 or 60 days prior to death, and whether residents had been admitted to hospitals within the last seven, 30, or 60 days prior to death.
The researchers learned that nursing home residents who had palliative care treatment experienced lower rates of hospitalization compared to very similar residents who hadn't received palliative care treatment. They also learned that hospital rates were even lower for residents who had palliative care consultations earlier rather than later in their illness.
What's more, difficult transitions were also lower for residents who got palliative care consultations sooner. According to the researchers, palliative care consultations improved end-of-life nursing home care by reducing emergency care use and hospital admissions.
It's important to remember that palliative care is not the same as hospice care. Though both provide comfort, hospice is typically prescribed when someone receives a diagnosis that will result in death within six months. Palliative care treatments, on the other hand, can begin at the same time a doctor diagnoses you with a serious illness and can be given while you're being treated for the illness.
Professionals who offer palliative care include doctors, nurses, dietitians, social workers, psychologists, massage therapists, and chaplains.
Healthcare providers can offer palliative care treatment consultations during treatment for serious health problems by accessing Medicare Part A skilled nursing home care. If Medicare hospice is not an option or not wanted, residents and families may want to ask whether palliative care consults are available to assist the nursing home staff in addressing physical and other concerns that can accompany advanced serious illness.
More information: Susan C. Miller et al, Palliative Care Consultations in Nursing Homes and Reductions in Acute Care Use and Potentially Burdensome End-of-Life Transitions, Journal of the American Geriatrics Society (2016). DOI: 10.1111/jgs.14469