Hospitals skimping on palliative care consults before sending patients to nursing homes, researchers say
Hospitals often are not doing palliative care interventions with older trauma patients who go on to a skilled nursing facility, according to recently announced findings.
The investigators analyzed 92 patients who were admitted to Newark's University Hospital in 2012 with traumatic injuries, and who were 55 or older. Of the 17 patients who ultimately died from their injuries, 90% received a palliative care consultation about end-of-life care options. However, of the 46 people discharged to a facility, only about a third had a conversation about palliative care at the hospital.
Based on their research, the investigators assert that palliative care consultations would benefit all patients who are 75 or older and/or have an “altered level of consciousness,” have a very severe injury, a traumatic brain injury or a blood transfusion. These people are more likely to die or be discharged to a facility rather than home, the researchers determined.
Without a palliative care intervention, these types of trauma patients often are going to a SNF without an advance directive in place or other care preferences established, which could compromise their quality of life, the investigators noted.
“A conversation about what older trauma patients desire in end-of-life care should occur sooner than later,” stated senior investigator Anne C. Mosenthal, M.D., FACS, a trauma surgeon and palliative medicine physician at University Hospital.
The results were shared this week at the American College of Surgeons Clinical Congress in San Francisco.