Pew Research surveys found in 1990 that 12 percent of Americans had a “living will,” a figure that rose to just 29 percent by 2005. So on a nearly daily basis, the palliative care specialist Dr. Joshua Lakin said in an interview, “I’d see someone who’d had lung cancer for several years, who’d been in and out of the hospital, had seen 20 doctors, and still hadn’t thought about the future and his priorities. It kind of blindsided me.” So Dr. Lakin, who just completed a fellowship at the University of California, San Francisco, and some colleagues took an entirely…
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With more than 1.6 million Americans now living in nursing homes, many of us are all too familiar with the debilitating cycle of a nursing home admission followed by repeated hospitalizations, a spiraling into decline, and ultimately death. A Brown University study published in The New England Journal of Medicine, confirms what many of us have observed: health care transitions, such as moves in and out of the hospital from a nursing home, do not lead to positive outcomes. More common are frequent medical errors; poor care coordination, infections and additional medications. For patients with acute dementia, these transitions can…
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