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Limited‐Treatment Policies in Long‐Term Care Facilities
Author(s) -
Miles Steven H.,
Ryden Muriel B.
Publication year - 1985
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1985.tb01780.x
Subject(s) - medicine , dignity , long term care , nursing , isolation (microbiology) , intensive care medicine , medical emergency , microbiology and biotechnology , political science , law , biology
Two‐thirds of the long‐term care facilities in Minnesota accept do‐not‐resuscitate (DNR) orders and 73% accept care plans to limit medical treatment. The major objectives for limited‐treatment plans cited by the 16.3% of facilities with administrative protocols for such plans was to provide for the resident's physical and emotional comfort and dignity. Nearly half of the protocols said limited treatment plans were intended to limit emergency care or hospitalization or to allow death to occur. Protocols advocated the alleviation of physical discomfort, anxiety, and social isolation. Tube feedings were not recommended when oral feeding became impossible. Airway suctioning, oxygen, or antibiotic treatment was suggested only as needed to alleviate suffering. Only a fourth of the protocols described a primary role for the resident in these decisions. This study demonstrates that nursing homes are developing administrative protocols for the formulation of limited‐treatment plans and suggests that model policy statements describing key decision‐making principles, issues, and procedural safeguards could play a constructive role in this process.