Guide helps nursing home residents, their families talk about hospitalization

One nursing school is trying to tell family members that the hospital isn’t the only, or sometimes best, place for their loved ones to be treated.

Family members have a large say in whether nursing home residents are transferred to the hospital. The Christine E. Lynn College of Nursing at Florida Atlantic University has created an evidence-based decision guide entitled, “Go to the Hospital or Stay Here? A Decision Guide for Patients and Families.”

Hospitalizations come with possible complications and health risks, such as falls, pressure ulcers, infections and disorientation, says Ruth Tappen, EdD, Christine E. Lynn Eminent Scholar and professor in FAU’s College of Nursing in a news release. They also come at a high cost. Medicare spent $14.3 billion in fiscal year 2011 on hospital stays for nursing home residents.  

“Even when the resident has a palliative condition that can be treated in the nursing home, there are some instances where family members may still demand hospitalization,” Tappen says. “They might just be uniformed about the actual prognosis of the resident or simply unaware of the treatment options available in the nursing home. This is why tools like the guide we have developed are crucial to enhance communication and information sharing between all parties involved in the decision-making process.”

In a parent study, Tappen and colleagues identified two of the most frequent reasons given by nursing home staff for avoidable or potentially avoidable hospital transfers:

  • insistence by the resident or family member and
  • communication gap between nursing staff, primary care providers and families.

The guide was funded through a $50,000 Engagement Award from the Patient-Centered Outcomes Research Institute (PCORI). It will be available on paper and electronically and translated into the top five languages spoken in the United States, including Spanish. 

Topics: Clinical