Caring About Residents’ Experiences and Symptoms (CARES) Program: A Model of Palliative Care Consultation in the Nursing Home

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Abstract

Objectives:

To describe the CARES program, a model of palliative care for nursing home residents.

Design:

Descriptive analysis of the Caring About Residents’ Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents.

Program evaluation:

The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred.

Results:

170 nursing home residents were seen by CARES Program between February 2013 to December 2015, 48% for skilled services, and 52% for long term care. Majority of referrals were for goals of care and concurrent symptom management. Following consultation, 67% of residents had a change in code status. Of residents desiring a palliative course 90% were never hospitalized. Overall, 53% of residents died; and those in long term care dying more often with hospice.

Conclusion:

The CARES program of palliative consultation addresses the needs of nursing home residents. The model has potential to be reproducible in in other communities.

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