Improved Access to Palliative Care = Improved Quality of Care

February 23, 2018 | Aging Services Risk, Quality, & Safety Guidance

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​Palliative care programs can improve quality of life for people with a diagnosed life-threatening or terminal illness; however, most nursing homes do not initiate palliative care until a resident has a six-month life expectancy and therefore qualifies for the Medicare/Medicaid hospice benefit. In an article published in the January/February 2018 issue of Annals of Long-Term Care and through its partnership with ECRI Institute, the author argues for increased access to palliative care programs as soon as a resident's illness is diagnosed, to provide necessary information and care through each stage of illness and to ease the burdens of transitions of care. The author cites the Nursing Home Palliative Care Collaborative of Rhode Island as a prime example of how organizations can improve palliative care infrastructures. The collaborative (funded by CMS) provides “education, best practices, and interfacility discussion, focusing efforts on the following domains of care: identifying proxy decision makers and engaging in advance care planning; talking with residents about their prognosis; conducting care conferences that discuss goals for care; implementing procedures for pain assessment; and assessing the need for and access to spiritual care. " The author advises providers to ensure their policies and procedures align with state regulations—many states have enacted laws requiring providers give residents and their families information about and access to end-of-life and palliative care—and to be conscious of ethnic and racial disparities regarding access to and use of palliative care programs. It is helpful to ensure all information provided to residents and their families is offered in multiple languages appropriate to local demographics.

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