• Publications
  • Influence
Family perspectives on end-of-life care at the last place of care.
Many people dying in institutions have unmet needs for symptom amelioration, physician communication, emotional support, and being treated with respect, according to this evaluation of the US dying experience at home and in institutional settings.
The clinical course of advanced dementia.
Patients with health care proxies who have an understanding of the prognosis and clinical course are likely to receive less aggressive care near the end of life, and these complications are associated with high 6-month mortality rates.
Driven to tiers: socioeconomic and racial disparities in the quality of nursing home care.
A proactive policy stance is recommended to mitigate the consequences of quality competition in nursing home care, which may result in driving poor homes out of business and will disproportionately affect nonwhite residents living in poor communities.
Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009.
Among Medicare beneficiaries who died in 2009 and 2005 compared with 2000, a lower proportion died in an acute care hospital, although both ICU use and the rate of health care transitions increased in the last month of life.
The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation.
Older patients readily understand prognostic information, which influences their preferences with respect to CPR, and most do not want to undergo CPR once a clinician explains the probability of survival after the procedure.
End-of-life transitions among nursing home residents with cognitive issues.
Burdensome transitions are common, vary according to state, and are associated with markers of poor quality in end-of-life care.
Clinical and organizational factors associated with feeding tube use among nursing home residents with advanced cognitive impairment.
Feeding tube use was more likely among residents living in facilities that had a smaller proportion of residents with do-not-resuscitate orders, had a higher prevalence of nonwhite residents, and lacked a nurse practitioner or physician assistant on staff.