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Indicators of Quality Medical Care for the Terminally Ill in Nursing Homes
Author(s) -
Keay Timothy J.,
Fredman Lisa,
Taler George A.,
Datta Soma,
Levenson Steven A.
Publication year - 1994
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.1532-5415.1994.tb06557.x
Subject(s) - medicine , terminally ill , data extraction , medical care , nursing homes , nursing , medline , quality (philosophy) , family medicine , palliative care , philosophy , epistemology , political science , law
PURPOSE : To identify medical care indicators for nursing home terminal care. DATA SOURCES : Studies examining care of terminally ill patients were identified using computer, bibliography, and expert searches; input from nursing home medical directors in Maryland; and input from expert geriatricians. STUDY SELECTION : More than 900 articles, books, and abstracts from meetings covering medical care for terminally ill patients were reviewed. Information from more than 100 publications is included. DATA EXTRACTION : Indicators of medical care for terminally ill patients, which can be used to quantify performance with respect to standards, guidelines, and options, were identified initially through review of the literature. DATA SYNTHESIS : Indicators were refined by input from medical directors of Maryland long‐term care facilities and subsequent review by expert geriatricians. CONCLUSIONS : Minimum standards for which 100% performance is expected are communication of advance directives, attention to pain control, and attention to relief of dyspnea. Performance indicators for medical care guidelines and options in terminal care of nursing home patients are also described.