Ruth Tappen

A new guide for long-term care residents and their families explaining the risks and benefits of treatment in long-term care versus transfer to the hospital is now available. It is titled Go to the Hospital or Stay Here? 

Studies of hospital admissions from U.S. nursing homes suggest that resident and family insistence on transfer accounts for as much as 15% to 18% of these admissions. It is understood few medical providers will refuse to transfer the resident under these circumstances.

Little attention has been paid to residents and families as contributors to potentially preventable transfers until my research team developed an informative guide for nursing home residents and families. The guide is based on interviews of 271 residents, family members, and care providers.

Our interviews with the residents and family members told us that most had not thought about this before. It is not easy to focus on weighing risks and benefits at the time a resident becomes ill. Discussing it ahead of time allows them to prepare mentally for such an eventuality.

We found that unless a resident or family member had been through this before with another loved one, they were not familiar with many of the terms currently in use such as hospitalist, living will, DNR, and so forth. The research was supported by Contract Number 343268-2 from PCORI (Patient-Centered Outcomes Research Institute). 

The guide is copyrighted by FAU, but is available for free at in English and Spanish. It will be translated into Creole, French, Chinese and Tagalog.

A multipage version includes an introduction to the reasons for creating the guide and considerations for remaining in long-term care or going to the hospital, as well as a decision flow chart, FAQs and quotes from the people interviewed. A full report on the results of the interviews may be found in the Journal of Gerontological Nursing.

Ruth Tappen, Ed.D., RN, FAAN, is the Christine E. Lynn eminent scholar in Nursing at Florida Atlantic University. All statements are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.