Cardiac Patients at End of Life in the Emergency Department

2014 ◽  
pp. 91-105
Author(s):  
Derrick Lowery ◽  
Christopher R. Carpenter
Keyword(s):  
Emergency Department ◽  
End Of Life ◽  
Cardiac Patients

Nursing Home Resident, Family, and Staff Perspectives on Hospital Transfers for End-of-Life Care

2021 ◽  
pp. 003022282199770
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Terminally Ill ◽  
South Florida ◽  
Care Planning ◽  
Life Care ◽  
Advance Care

Residents who are terminally ill often experience transfers to the emergency department resulting in hospitalizations, which may be potentially avoidable with treatment in the nursing home. This qualitative study explored the perspectives of 15 residents, 10 family members, and 20 nursing home staff regarding end-of-life care and the circumstances prompting resident transfers. Data analysis of participant interviews conducted January to May 2019 in a South Florida nursing home identified four themes related to transfer to the hospital: time left to live, when aggressive treatments would be unavailing, not knowing what the nursing home can do, and transfer decisions are situation-dependent. Study findings underscore the importance of increasing resident and family awareness of treatments available in the nursing home and person-centered advance care planning discussions. Further research should explore the reasons for residents’ and family members’ choice of aggressive therapies and their goals for care at the end of life.

scholarly journals Palliative Care Symptom Assessment for Patients with Cancer in the Emergency Department: Validation of the Screen for Palliative and End-of-Life Care Needs in the Emergency Department Instrument

2011 ◽  
Vol 14 (6) ◽  
pp. 757-764 ◽  
Author(s):  
Christopher T. Richards ◽  
Michael A. Gisondi ◽  
Chih-Hung Chang ◽  
D. Mark Courtney ◽  
Kirsten G. Engel ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Symptom Assessment ◽  
Life Care ◽  
Care Needs ◽  
Patients With Cancer

scholarly journals Patterns of emergency department attendance among older people in the last three months of life and factors associated with frequent attendance: a mortality follow-back survey

2019 ◽  
Vol 48 (5) ◽  
pp. 680-687
Author(s):  
Anna E Bone ◽  
Catherine J Evans ◽  
Lesley A Henson ◽  
Wei Gao ◽  
Irene J Higginson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Health Professional ◽  
End Of Life ◽  
Respiratory Disease ◽  
Community Support ◽  
Free Text ◽  
Coordinated Care ◽  
Factors Associated ◽  
Increased Risk

Abstract Background frequent emergency department (ED) attendance at the end of life disrupts care continuity and contradicts most patients’ preference for home-based care. Objective to examine factors associated with frequent (≥3) end of life ED attendances among older people to identify opportunities to improve care. Methods pooled data from two mortality follow-back surveys in England. Respondents were family members of people aged ≥65 who died four to ten months previously. We used multivariable modified Poisson regression to examine illness, service and sociodemographic factors associated with ≥3 ED attendances, and directed content analysis to explore free-text responses. Results 688 respondents (responses from 42.0%); most were sons/daughters (60.5%). Mean age at death was 85 years. 36.5% had a primary diagnosis of cancer and 16.3% respiratory disease. 80/661 (12.1%) attended ED ≥3 times, accounting for 43% of all end of life attendances. From the multivariable model, respiratory disease (reference cancer) and ≥2 comorbidities (reference 0) were associated with frequent ED attendance (adjusted prevalence ratio 2.12, 95% CI 1.21–3.71 and 1.81, 1.07–3.06). Those with ≥7 community nursing contacts (reference 0 contacts) were more likely to frequently attend ED (2.65, 1.49–4.72), whereas those identifying a key health professional were less likely (0.58, 0.37–0.88). Analysis of free-text found inadequate community support, lack of coordinated care and untimely hospital discharge were key issues. Conclusions assigning a key health professional to older people at increased risk of frequent end of life ED attendance, e.g. those with respiratory disease and/or multiple comorbidities, may reduce ED attendances by improving care coordination.

Sign in / Sign up

Export Citation Format

Share Document