Burdensome Health Care Transitions In the Last Months of Life Are Very Common

Written by Adam Peck Category: Nursing Homes January 23rd, 2013 2 min read

Burdensome health care transitions in the last months of life are common and are associated with poor quality end-of-life care, according to a study published in the Sept. 29, 2011 issue of the New England Journal of Medicine.

Investigations were done concerning health care transitions among 474,829 nursing home residents with advanced cognitive and functional impairment 120 days before death says California Nursing Home Abuse and Neglect Lawyer Steven Peck.

Be Aware of Burdensome Transitions for the Elderly

Three types of transitions were classified as being burdensome: those occurring in the last three days of life, absence of nursing home continuity following hospitalization during the last 90 days of life, and multiple hospitalizations in the last 90 days of life.

The associations between regional rates of burdensome transitions and the likelihood of feeding-tube insertion, hospitalization in an intensive care unit (ICU) in the last month of life, the presence of a stage IV decubitus ulcer, and hospice enrollment in the last three days of life were assessed.

The investigators found that 19 percent of the patients had at least one burdensome transition, with variation across states (range, 2.1 to 37.5 percent). Blacks, Hispanics, and those without advance directives had an increased risk of burdensome transition. Compared to patients in the lowest category of burdensome transitions, those in the highest area had significantly increased rates of feeding-tube insertion (adjusted risk ratio [aRR], 3.38), ICU time in the last month of life , late hospice enrollment, and a stage IV decubitus ulcer.

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Written by Adam Peck

Expertise: Personal Injury

Adam J. Peck, ESQ is a principal with Peck Law Group, APC. In 2008, Mr. Adam Peck received his Juris Doctorate from Whittier Law School where he graduated Cum Laude. His practice is primarily dedicated to representing Elders, Dependent Adults, along with their loved ones and family members, who have suffered horrific personal injuries.