ArticleJournal of palliative medicine2015
End-of-Life Care in Nursing Homes with Greater versus Less Palliative Care Knowledge and Practice.
Article in Journal of palliative medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A Systematic Review of Nursing Home Palliative Care Interventions: Characteristics and Outcomes.Journal of the American Medical Directors Association · 2020Pooled it
- Hospitalizations of nursing home residents at the end of life: A systematic review.Palliative medicine · 2019Pooled it
- Factors associated with older people's emergency department attendance towards the end of life: a systematic review.European journal of public health · 2019Pooled it
- Nursing Home Palliative Care Referral Process, Barriers, and Proposed Solutions: A Qualitative Study.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Utilization and quality of primary and specialized palliative homecare in nursing home residents vs. community dwellers: a claims data analysis.BMC palliative care · 2025Article
- End-Of-Life Care Planning and Bereavement Practices Among Adult Day Services Centers, 2018.The American journal of hospice & palliative care · 2024Article
- Impact of the Physician Orders for Life-Sustaining Treatment (POLST) Program Maturity Status on the Nursing Home Resident's Place of Death.The American journal of hospice & palliative care · 2021Article
- Racial disparity in end-of-life hospitalizations among nursing home residents with dementia.Journal of the American Geriatrics Society · 2021Article
- 'Bare-bones' to 'silver linings': lessons on integrating a palliative approach to care in long-term care in Western Canada.BMC health services research · 2021Article
- Article
- Quality of Palliative and End-Of-Life Care in Hong Kong: Perspectives of Healthcare Providers.International journal of environmental research and public health · 2020Article
- The last week of life of nursing home residents with advanced dementia: a retrospective study.BMC palliative care · 2019Article
- Integration of Palliative Care and Infection Management at the End of Life in U.S. Nursing Homes.Journal of pain and symptom management · 2019Article
- Care in Nursing Facilities after Palliative Consult.Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association · 2018Article
- Palliative Care Consults in U.S. Nursing Homes: Not Just for the Dying.Journal of palliative medicine · 2018Article
- End-of-Life Care in Nursing Homes: From Care Processes to Quality.Journal of palliative medicine · 2016Article
- Communication with Residents and Families in Nursing Homes at the End of Life.Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association · 2016Article
- Nursing Home Staff Palliative Care Knowledge and Practices: Results of a Large Survey of Frontline Workers.Journal of pain and symptom management · 2015Article
- Diffusion of palliative care in nursing homes: lessons from the culture change movement.Journal of pain and symptom management · 2015Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundMany older adults in nursing homes (NHs) lack palliative care (PC) access; but little is known about whether access to PC knowledge and practice (beyond hospice) impacts residents' care.
objectiveThe study objective was to evaluate how differing levels of NH PC knowledge and practice are associated with residents' end-of-life health care use.
methodsIn 2009/10 we surveyed a stratified random sample of U.S. NHs and asked directors of nursing (DONs) PC knowledge and practice questions from Thompson and colleagues' validated PC Survey. This study includes 1981 NHs with complete survey responses and the 58,876 residents who died in these facilities between July 2009 and June 2010. Medicare resident assessment (minimum data set [MDS]) and claims data from July 2009 through June 2010 were used to determine outcomes and a NH's hospice use. Multivariate logistic regressions examined whether residing in NHs with higher PC scores was associated with documented six-month prognoses and receipt of aggressive treatments, including hospital and emergency room (ER) use in the last 30 days of life.
resultsControlling for NH hospice use, being in a NH with higher PC care knowledge scores was associated with residents having a higher likelihood of documented six-month prognoses and lower likelihoods of having feeding tubes, injections, restraints, suctioning, and end-of-life hospital and ER use. Being in a NH with higher PC practice scores was associated with a lower likelihood of having feeding tubes and ER visits.
conclusionPolicies and advocacy promoting the development of NH PC knowledge and practices could potentially improve care and reduce hospital and ER use.
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