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Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursinghomes. He’s been a hospice and nursinghome director.
In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that she would not want to continue in this state. On the one hand, this was unfortunate, as it meant Nancy Cruzan could not be disconnected from the feeding tube immediately. And I think that’s where we want to be.
The program is designed to recognize up-and-coming industry members who are shaping the next decade of senior housing, skilled nursing, home health, and hospice care. Mobile technology is not just used for documentation, but it’s really an integrated workflow for the caregiver at the bedside.
And Katie, I was going through your Twitter feed, and a tweet I noticed was this one, “All opioid guidelines caution long-term use in people with active substance use disorder.” Eric: Who manages, once a day, methadone once they’re admitted to a nursinghome? It’s not well-documented. Katie: Yep.
Joel: And by the way, I should mention that some of the work that’s been done in the past on patients with dementia in the hospital, it’s been based on Emily Finlayson’s work looking at surgery, but really looking only at nursinghome patients. You’re not going to end up going back home after the surgery.
In a separate study in Chest , Lauren found pre-ICU frailty was associated with post-ICU disability and new nursinghome admission. He, his Twitter feed though is brilliant. So, maybe the person with advanced dementia is coming in from the nursinghome and nobody can find the living will from however many years ago.
Hospice staff refused to feed the person who was no longer able to safely swallow. That did it… There once was an elderly woman, in her 80’s, suffering from dementia and currently a flu like illness that had been going around the nursinghome. Hospice staff gave the person medication. That did it. That did it. That did it.
Potential that documenting advance directives without a robust conversation about prognosis might have led to these findings. A lot has changed, but what motivated the study was a recognition that most advanced care planning interventional research had been undertaken in nursinghomes. So intubation, cpr, feeding tubes.
One of the most common frustrations hospice nurses have is related to how long it takes to complete hospice documentation. Then, documents from the referral source (i.e. doctor, hospital, nursinghome) are added to the electronic medical record. They told the family that the hospice would supply the tube feedings.
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