Has anyone noticed how a quick internet search for “palliative care” immediately pulls up lists of advertisements for nursing homes? I am puzzled by these results. During my years of providing palliative care in the community, I felt that palliative care (outside of hospice) was rarely delivered in the nursing home setting.  Lima and Miller (2018) support my perception. In their study of 54 nursing homes over the course of two years, they found only 4% of the nursing home residents received a palliative care consult, leaving the remaining 96% without this supportive care. So why does an internet search for the palliative care specialty produce a list of places that most likely do not offer this care?

Ersek and colleagues (2022) seek to change this discrepancy. These authors offer a thorough analysis of the existing deliveries of palliative care and a new model in which palliative and end-of-life care are integral to high-quality nursing home care. They make 4 recommendations including promoting internal palliative care training, ensuring payment for this care, incorporating quality palliative sensitive indicator metrics, and integrating external palliative care services. This is foundational work and a significant contribution to supporting nursing home administrators in their constant quest of improving care for their residents.

Ersek, M., Unroe, K. T., Carpenter, J. G., Cagle, J. G., Stephens, C. E., & Stevenson, D. G. (2022). High-quality nursing home and palliative care—one and the same. Journal of the American Medical Directors Association, 23(2), 247-252.

Lima, J. C., & Miller, S. C. (2018). Palliative care consults in US nursing homes: not just for the dying. Journal of Palliative Medicine, 21(2), 188-193.