Code Status Decision‐Making in a Nursing Home Population

Abstract

Prehospital code status decisions can be made effectively within the NH setting. Outside of medical intensive care, DNR orders have no impact on NH and hospital care intensity in the short term. In the final 6 months of life, however, hospital use is less for the DNR subgroup.

Nursing Home Resident Use of Care Directives

“…We considered a resident as having a treatment directive if they had a DNR order. Classifying living wills and durable powers of attorney as advance directives and classifying DNR orders as treatment directives has been done in previous studies (5,11).…”

Advance care planning in residential care

“…9 The law regulating the use of ACDs in Australia is a mixture of legislation and case law and in many respects subject to uncertainty.'" In NSW the Guardianship Act 1987 (NSW) provides for a surrogate decision maker where a person is no longer competent to make decisions about health care.…”

Racial variation in the use of do-not-resuscitate orders

“…Though investigation of racial and ethnic variation in the utilization of surgical procedures and in access to primary care has provided important insights into inequities in the current delivery system, [4][5][6][7][8][9][10][11][12] relatively few studies have examined racial variation in the use of DNR orders. Moreover, prior studies largely focused on patient preferences for endof-life care and often involved small sample sizes, [13][14][15] single institutions, 14,16 or highly selected patient populations, 13,15,[17][18][19][20][21][22] raising questions about their generalizability. In addition, some larger studies involved patients hospitalized prior to the Patient Self-Determination Act, 23,24 and thus, may not be representative of current practice.…”