The challenges and opportunities in providing end-of-life care in nursing homes.
The challenges and opportunities in providing end-of-life care in nursing homes.
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DOI：
10.1089/10966210360510118
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发表时间：
2003-02-01
影响因子：
2.8
通讯作者：
Wilson, Sarah A
中科院分区：
文献类型：
--
作者：
Ersek, Mary;Wilson, Sarah A
在美国，大约20%的死亡发生在养老院。随着人口继续老龄化，这一比例预计还会增加。作为临终关怀的场所，养老院提供了挑战和机遇。本文探讨了阻碍养老院提供高质量临终关怀的因素，如工作人员和医生培训不足，监管和报销问题，症状管理不善，以及缺乏对工作人员，居民和家庭的心理支持。除了讨论提供临终关怀的障碍外，本文还探讨了养老院及其工作人员的特点，这些工作人员支持临终病人的护理。还包括提供临终关怀的疗养院，包括提供临终关怀服务，专门的姑息治疗单位和咨询服务的模式的概述。最后，本文讨论了教育计划和当前的教育举措，以提高临终关怀在养老院。
Approximately 20% of deaths in the United States occur in nursing homes. That percentage is expected to increase as the population continues to age. As a setting for end-of-life care, nursing homes provide both challenges and opportunities. This article examines factors that impede the delivery of high-quality end-of-life care in nursing homes, such as inadequate staff and physician training, regulatory and reimbursement issues, poor symptom management, and lack of psychosocial support for staff, residents, and families. In addition to discussing hindrances to providing end-of-life care, this article explores characteristics of nursing homes and their staff that support the care of terminally ill residents. Also included is an overview of models for delivering end-of-life care in nursing homes, including provision of hospice services, specialized palliative care units, and consultation services. Finally, this article discusses educational programs and current educational initiatives to enhance end-of-life care in nursing homes.