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Biomedical subjects

Steven Zweig

Publications and source records attributed to Steven Zweig.

8 recordsLinked to original sources
PubMed2003

Hospice and nonhospice nursing home residents.

OBJECTIVE: To compare hospice residents in nursing homes with residents who are noted as end-stage, but not in hospice programs. DESIGN: Descriptive comparison of the outcomes reported on Minimum Data Set (MDS) for all residents admitted to Missouri nursing homes in 1999. SETTING: Nursing homes. PARTICIPANTS: Residents of nursing homes designated as either hospice or end-stage on admission MDS. MEASUREMENTS: Percentage of hospice residents having various conditions as compared with other end-stage residents. RESULTS/CONCLUSIONS: Overall the clinical conditions of both hospice and nonhospice end-stage residents were similar. A greater percentage of hospice residents were found to have living wills, DNR orders, and cancer, and to be in moderate or severe pain. Hospice and nonhospice residents experienced similar time from admission to death or discharge (20 and 36 days, respectively). Based on the clinical condition of the two groups, it would appear that there are limited clinical reasons for the low utilization of the hospice benefit in nursing homes. The increased prevalence of advance care planning may lead toward use of hospice or may result from hospice enrollment. Hospice services seem to be thought of more frequently for residents with cancer and residents experiencing pain. Nursing homes must recognize their role as caregivers to the dying before palliative care is seen as a need for nursing home residents. Nursing homes need education in determining when a patient is appropriate for palliative care as only 4% are designated as end of life, and only 2% are shown to be receiving hospice care in hospice-contracted facilities.

Activities of Daily Living↗
PubMedDate not supplied

End-of-life care in U.S. nursing homes: a review of the evidence.

OBJECTIVES: The purpose of this study was to systematically review the empiric evidence on end-of-life care in nursing homes in the United States The guiding research question for this review was what is the state of research evidence in end-of-life care in long-term care? DESIGN: We conducted a systematic review of the literature. DATA: The review was limited to published and indexed research in peer-reviewed journals in five major databases between 1995 and October 2002. RESULTS: The initial search yielded a total of 395 articles. The search was narrowed, focusing on nursing homes in the United States and empiric research. The result was 43 articles related to research in end-of-life care in American nursing homes. It was categorized into eight foci: prognosis, pain, hospice, hospitalization, advanced care planning, communication, family perceptions, and miscellaneous. CONCLUSION: There is a dearth of research published in end-of-life care in the nursing home setting. What is available is primarily descriptive. The empiric research only documents poor end-of-life care in U.S. nursing homes. Empiric evidence has grown in this area, but there is now a need for research of creative and innovative solutions aimed at improving the quality of end-of-life care in this setting.

Health Services Needs and Demand↗
PubMedDate not supplied

Bert's Dad.

Explore the source record for details and available documents.

Journal Article↗
PubMedDate not supplied

End-of-life care in U.S. nursing homes: a review of the evidence.

OBJECTIVES: The purpose of this study was to systematically review the empiric evidence on end-of-life care in nursing homes in the United States The guiding research question for this review was what is the state of research evidence in end-of-life care in long-term care? DESIGN: We conducted a systematic review of the literature. DATA: The review was limited to published and indexed research in peer-reviewed journals in five major databases between 1995 and October 2002. RESULTS: The initial search yielded a total of 395 articles. The search was narrowed, focusing on nursing homes in the United States and empiric research. The result was 43 articles related to research in end-of-life care in American nursing homes. It was categorized into eight foci: prognosis, pain, hospice, hospitalization, advanced care planning, communication, family perceptions, and miscellaneous. CONCLUSION: There is a dearth of research published in end-of-life care in the nursing home setting. What is available is primarily descriptive. The empiric research only documents poor end-of-life care in U.S. nursing homes. Empiric evidence has grown in this area, but there is now a need for research of creative and innovative solutions aimed at improving the quality of end-of-life care in this setting.

Advance Directives↗
PubMedDate not supplied

Questions & answers about hospice: a guide for Missouri's physicians.

Hospice provides multidisciplinary care to dying patients with and without cancer. Most adults would prefer to be cared for in their home or that of a family member. This guide provides answers to the questions most commonly asked of physicians. Its goal is to facilitate a better understanding of what hospice does, who is eligible, physician roles, and how physicians can use hospice to help their patients.

Eligibility Determination↗
PubMedDate not supplied

Helping older patients and their families decide about end-of-life care.

Three-fourths of those who die in America are 65 or older. In all but the cases where death is sudden and unexpected, decisions frequently must be made about whether to limit treatment. In this paper, we provide a framework and specific tools that may help physicians in talking to older patients and their family members about end-of-life care. After briefly reviewing the demography of dying and methods of advance care planning, we propose a four-step process for deciding about end-of-life care: 1. Identifying patient preferences. 2. Communicating about medical prognosis. 3. Defining goals of care. 4. Implementing a management plan consistent with those goals. The paper concludes with special considerations about four common experiences of dying as an older person: chronic diseases with acute exacerbations (e.g. congestive heart failure or chronic obstructive lung disease), cancer, end stage dementia, and unexpected catastrophic decline.

Advance Directives↗