Looking beyond the 'form' to complex interventions needed to improve end-of-life care

Article Abstract:

Those involved in end-of-life care should look beyond the 'form' to the substance to see the complex interventions needed to improve this important area of treatment. A one-page form that has been developed, the Physician Orders for Life Sustaining Treatment (POLST) is useful, but not a sufficient, step to improve medical care for the dying in long-term care facilities and to help their families. This form calls for not resuscitating residents in nursing homes. These patients need better symptom management and other palliative care.

Aged, Elderly, Management, Physiological aspects, Pain, Pain management, Terminal care, Long-term care facilities, Long term care facilities

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The impact of regular multidisciplinary team interventions on psychotropic prescribing in Swedish nursing homes

Article Abstract:

Improved communication among the various members involved in caring for institutionalized elderly patients can reduce the use of psychotropic drug use. Psychotropic drug use was compared in 15 Swedish nursing homes that participated in a team approach to care and 18 that did not. In the homes that participated in the team approach, antipsychotic drug use dropped 19%, benzodiazepine use dropped 37% and antidepressant use dropped 59%.

Evaluation, Health care teams

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Use of antipsychotic drugs in nursing homes: current compliance with OBRA regulations

Article Abstract:

Many nursing homes are complying with some of the provisions of the 1987 Omnibus Budget Reconciliation Act (OBRA) governing antipsychotic drug use. Analysis of the pharmacy records of 1,573 patients at eight nursing homes revealed that 18% were receiving antipsychotic drugs. In 71% of the records, an appropriate diagnosis requiring these drugs was documented and in 90%, the dosage was within OBRA guidelines.

Laws, regulations and rules, Nursing homes

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