At a glance
ClinicalIndex Comparison Record- ✓Age 60 years or older
- ✓Admitted to SNF for post-acute care following recent hospitalization
- ✓Documented Alzheimer's disease, related dementia, or cognitive impairment (BIMS score ≤12)
- ✓At least one indicator for palliative care need: provider would not be surprised if patient died within 1 year, patient would benefit from advance care planning or symptom management, frequent hospital/SNF admissions, complex care requirements, decline in function, feeding intolerance, unintended weight loss, or previous hospice assessment/enrollment and discharge
- ✕Previously received or currently referred for palliative care by primary care team
- ✕Discharge plan within 48 hours of screening
- ✕Currently receiving hospice care
- ✕Does not have at least one indicator of palliative care need
Standardized by ClinicalIndex from the ClinicalTrials.gov record · verify against the source.
Palliative Care Consultations for Persons With Alzheimer's Disease and Related Dementia and Cognitive Impairment in the Medicare Skilled Nursing Facility (SNF) Setting
In Brief
A clinical study evaluating Palliative Care Consultation for Advance Care Planning and 3 related conditions. Completed, enrolled 7 participants across 1 site.
Detailed Summary
Alzheimer's disease and related dementias (ADRD) are serious, life limiting illnesses with no known cure. Dementia is the fifth-leading cause of death in older adults and the majority of people with advanced dementia die in nursing homes (NHs). Miller et al reported that 40% of U.S. NH residents dying with advanced dementia received Skilled Nursing Facility (SNF) care in the last 90 days of life, and receipt of this care was associated significantly with poorer end-of-life outcomes, including a higher risk of dying in a hospital, compared to decedents with no SNF care. SNF care is a Medicare post-acute rehabilitation service delivered in NHs focused on intense rehabilitation and/or aggressive, disease-modifying therapies. Regardless of life expectancy, use of SNF care precludes access to Hospice services. Palliative care (PC) offers an evidence-based alternative.
Study Details
Timeline
Interventions
Trained provider will discuss illness trajectories, establish and communicate patient-directed goals that guide health care decisions, identify and treat illness-related symptoms, and identify psycho-spiritual needs and approaches to mitigate suffering