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For a lot of nursing house residents, a visit to the hospital could be a jarring expertise—one which leaves them confused and confused. But avoidable transfers occur far too typically, not solely disrupting a resident’s routine but in addition costing the U.S. well being care system $2.6 billion yearly.
When researchers on the College of Missouri just lately regarded on the decision-making course of for whether or not or to not switch nursing house residents to the hospital, they rapidly found that it is difficult—significantly for residents with cognitive impairment who could not be capable to talk their preferences.
“Untangling the complex web of avoidable nursing home-to-hospital transfers of residents with dementia” was printed in Alzheimer’s & Dementia.
Kimberly Powell, an assistant professor within the Sinclair Faculty of Nursing, led a current research that discovered nursing house residents with Alzheimer’s illness or associated dementias had been extra prone to have avoidable transfers to the hospital in comparison with residents with out dementia. These transfers typically stemmed from a mismatch between the care offered and the residents’ private choice.
Powell pointed to the more and more well-liked Age-Pleasant Well being System Initiative, which focuses on aligning care with what issues most to sufferers, emphasizing sufferers’ needs and minimizing trauma and danger.
“Not all residents with dementia can tell the nursing home staff they don’t want to be transferred to the hospital, so our research highlights the importance of documenting advanced care planning for residents ahead of time,” she mentioned. “Having those conversations early and often—ideally when a resident might be in an earlier stage of disease progression and better able to communicate their desires and values—helps us honor them through the rest of their life.”
For the research, Powell and her staff analyzed information from the Missouri High quality Initiative, a program that embedded superior apply registered nurses full-time into 16 Missouri nursing properties with greater hospitalization charges than the nationwide common.
“For those with a progressive disease like Alzheimer’s or dementia, we often find that they value having dignity later in life and being in a place that is comfortable while surrounded by people they know and love,” Powell mentioned.
“We also found that increasing nursing home staff support, training and resources can help residents receive the care they need as they age while remaining in the nursing home. We ultimately want to better support the staff who work in nursing homes.”
Ashley Woods, a doctoral scholar within the Sinclair Faculty of Nursing and nurse practitioner at a hospital in New Mexico, has encountered the problem firsthand.
“Sometimes, the patients’ forms are marked ‘do-not-transfer,’ so there seems to be a disconnect about the best course of action,” she mentioned.
“Those with dementia may experience a temporary episode of agitation in the nursing home, but by the time I see them in the hospital, everything looks good. Still, the transfers are often a traumatic and stressful experience for the residents and they don’t often align with the priorities and goals of the patient.”
Mentored by Powell, Woods’ analysis builds on the findings by exploring how continuously nursing house care groups deal with ache in residents with dementia.
“The work Ashley is doing around pain is so important and clinically meaningful,” Powell mentioned. “Two-thirds of nursing home residents have cognitive impairment, and that number is only projected to grow in the years ahead, so this will become an increasingly relevant topic to monitor going forward. At the end of the day, we want the nursing home residents’ goals, values and preferences to be put ahead of anything else.”
Extra data:
Kimberly R. Powell et al, Untangling the complicated net of avoidable nursing house‐to‐hospital transfers of residents with dementia, Alzheimer’s & Dementia (2024). DOI: 10.1002/alz.14292
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College of Missouri
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Researchers goal to cut back avoidable hospitalizations for nursing house residents with dementia (2025, January 3)
retrieved 4 January 2025
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