Studies: Some nursing home elderly get futile care

[SoCalDem]

Studies: Some nursing home elderly get futile care
http://www.google.com/hostednews/ap/article/ALeqM5hU4WyhNhnJuCwbUUt40Pb92SCQtwD9BB3NMO0

By ALICIA CHANG (AP) – 14 hours ago

LOS ANGELES — A surprising number of frail, elderly Americans in nursing homes are suffering from futile care at the end of their lives, two new federally funded studies reveal. One found that putting nursing home residents with failing kidneys on dialysis didn't improve their quality of life and may even push them into further decline. The other showed many with advanced dementia will die within six months and perhaps should have hospice care instead of aggressive treatment.

Medical experts say the new research emphasizes the need for doctors, caregivers and families to consider making the feeble elderly who are near death comfortable rather than treating them as if a cure were possible — more like the palliative care given to terminally ill cancer patients. "We probably need to be offering a palliative care option to many more patients to make the last days of their lives as comfortable as possible," said Dr. Mark Zeidel of the Beth Israel Deaconess Medical Center in Boston, who was not involved in the studies.

Palliative care focuses on managing symptoms of a disease and a main goal is to relieve pain at the end of life.

End-of-life care became a divisive issue in the national health care reform debate this summer after one proposal included Medicare reimbursement for doctors who consult with patients on end-of-life counseling. Critics called the counseling "death panels" and a step toward euthanasia. The Obama administration denied those claims, yet has signaled the Medicare benefit will be dropped.

The new studies are published in Thursday's New England Journal of Medicine. In one study, doctors looked at health records of 3,702 nursing home residents nationwide who started dialysis between 1998 and 2000. The average age was 73 and many had other health problems, including diabetes, heart disease and cancer. Within the first year, 58 percent died and another 29 percent declined in their ability to do simple tasks such as walking, bathing and getting dressed.

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[elleng]

1. I have a bit of knowledge about this.

Last year, my mother was in a nursing home due to a combination of conditions, including dementia, so your post is not relevant to her. But I spent some time at the nursing home, and in my opinion, many of the residents WERE receiving 'palliative care.' And for many, Hospice was involved.

Sounds like 'offering' such officially might be simply acknowledging what occurs, and maybe changing the terms and compensation in their contracts. NOT a good thing if it results in downgrading compensation for 'aides,' who have awful jobs and should be compensated adequately.

[SoCalDem]

2. My mother in law was in a Nursing Home (her choice..not ours)

she had a stroke, and was totally against having us move her in with us..she lived in kansas, and we were in calif.

She was unable to walk and yet that nursing home ordered at least FOUR pair of several-hundred-dollar pairs of shoes for her, filed claims for extensive dental work (she had very few teeth of her own), and every time my husband visited her, there were things missing.

She had a large network of friends who visited her as often as they could, but in the end she outlived them all

[Bluenorthwest]

3. My Mom is in a nursing home

The state where she lives requires a certain set of procedures, unless I, who have medical authority, tell them not to do it. The dental work is a perfect example. The facility had to keep ordering her new dentures, which she'd not wear, until I said 'please don't do that' and then put it in writing.
She has advance directives in place, in her ward no one is getting extreme life extending treatments. They keep them comfortable and clean and all of that. They are not trying to cure that which can not be cured. They clear every medical issue with me. Every little scratch or bump. Because I asked them to do so. No one is ordering anything my Mom does not need, does not use. The facility itself is well run and thoughtful. The aids and other staff are amazing people. They should all get huge raises.

[demodonkey]

4. Nursing Homes, in general, SUCK.

My mother was in at least 5 of them since she had a stroke in several years ago. In our experience the so-called "care" is horrible in these places. They all seemed to be out for the almighty dollar, and cared little to nothing about the patients (except as cash cows) or their families.

Social workers and other so-called "professionals" were not above blatant lying, and every single place she was in was understaffed, with overworked caregivers and nurses. I worried myself sick every single night she spent in one of those hellholes.

My mother is now home; I am caring for her, and it is MUCH better for both of us!