Many nursing home residents reaching the end of life are often vulnerable to burdensome symptoms and potentially improper care practices. Managing symptoms appropriately and preventing negative care practices from occurring is paramount to high-quality care for end-of-life patients. A recent study sought to identify common burdensome symptoms and potentially negative practices for nursing home residents reaching the end of life. The study also aimed to come up with a procedure for care providers in nursing homes to rate impact of symptoms and practices and create recommendations for action.
Researchers found that urinary incontinence, fecal incontinence and responsive behaviors were the three most prevalent symptoms experienced by nursing home patients. As for the most common practices, polypharmacy, antipsychotic use with no diagnosis of psychosis, and physical restraint use were the three most prevalent. Patients rated pain, responsive behaviors, and urinary incontinence as symptoms having the highest overall impact. Polypharmacy, hospital and emergency department transitions, and antipsychotic use with no diagnosis of psychosis were practices rated as having the most impact.
Symptoms and inappropriate care practices that cause major suffering to nursing home patients near the end of life must be addressed and corrected by nursing home staff in order to improve quality of dying.