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End-Stage Alzheimer's Patients Often Hospitalized Unnecessarily
Date:9/29/2011

iability may be another factor in unnecessary hospitalizations. He said current laws may need to be reformed.

"A lot of lawsuits stem from bad outcomes, not necessarily from bad care, and by nature, nursing homes will often have bad outcomes," said Ouslander, who also co-authored an editorial in the same issue of the journal.

Teno said that one solution is to have a so-called medical home, such as a nurse practitioner who reviews all care decisions. "Medical homes help align incentives to provide the right care at the right time for the right person," she said.

She added that families with loved ones in nursing homes can request a "Do not hospitalize" order. That way, the nursing home doesn't automatically send a patient to the hospital. Instead, the nursing home staff consults the family about their loved one's change in health and discusses the risks and benefits of each care option with the family.

More information

Learn more about evaluating caregivers for your loved one from the Alzheimer's Association.

SOURCES: Joan Teno, M.D., professor, health services, policy and practice, Warren Alpert Medical School, Brown University, Providence, R.I.; Joseph Ouslander, M.D., professor and senior associate dean for geriatric programs, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Fla.; Sept. 29, 2011, New England Journal of Medicine


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