Individuals in nursing homes with severe dementia are experiencing an increasing trend toward receiving high-intensity medical treatments despite the limited potential benefits and distress they cause. Yale investigators sought to understand the factors influencing this increasing trend.
Investigators performed a retrospective mixed-methods study through the Department of Veterans Affairs hospitals, focused on individuals at least 65 years old living in nursing homes with severe dementia. They found that the primary path to high-intensity care was through the uncertainty of family members in the best treatment course, while a large proportion of patients also received high-intensity care reflexively by their medical team before discussion with the surrogate decision-maker.
This study highlights how medical decision-making for this high-risk population is influenced by the difficult nature of making medical choices by surrogate decision-makers, as well as systems-level challenges within the general medical practice that can push forward high-intensity care without first searching for the input of the surrogate.
To learn more, read the publication, “High-Intensity Care for Nursing Home Residents with Severe Dementia Hospitalized at the End of Life: A Mixed Methods Study.”
Cohen, A. B., McDonald, W. M., O’Leary, J. R., Omer, Z. B., & Fried, T. R. (2024). High-Intensity Care for Nursing Home Residents With Severe Dementia Hospitalized at the End of Life: A Mixed Methods Study. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2024.02.001