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Advance care planning and hospital in the nursing home
Author(s)Gideon A Caplan, Anne Meller, Barbara Squires
Journal titleAge and Ageing, vol 35, no 6, November 2006
Pagespp 581-585
Sourcehttp://www.ageing.oxfordjournals.org
KeywordsMedical care ; Terminal care ; Dementia ; Management [care] ; Rights [elderly] ; Admission [hospitals] ; Nursing homes ; Evaluation ; Australia.
AnnotationEducation about dementia and advance care planning (ACP) in nursing homes (NHs) leads residents to receive treatment for acute illness in the NH rather than in hospital. A system of educating residents, their families, staff and general practitioners (GPs) about outcomes of dementia, ACP and hospital in the home was evaluated in this Australian study. The researchers employed one clinical nurse consultant who used the 'Let Me Decide' advance care directive. The intervention area consisted of two hospitals and the 12 nursing homes around them compared with one another, geographically separate, hospital and the 13 nursing homes around it. A controlled evaluation monitoring emergency admissions to hospital was conducted. Emergency calls to the ambulance service from intervention NHs decreased. The risk of a resident being in an intervention hospital bed for a day compared with a control hospital bed, per NH bed, fell by a quarter from being initially similar. There was no significant change in mortality in the intervention homes, but in the control homes mortality rose in the third year to be 11.1 per 100 beds higher than in the intervention area. (RH).
Accession NumberCPA-061211222 A
ClassmarkLK: LV: EA: QA: IKR: LD:QKH: LHB: 4C: 7YA

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