Honoring End-of-Life Wishes

Publishing in the May issue of JAMDA, the authors conducted a cross-sectional study of residents in New York State skilled nursing facilities. They found that while 61 percent of nursing home residents have ‘do-not-resuscitate’ orders, 12 percent had feeding restrictions, and only six percent have DNH orders in place.

“We set out with the goal of examining whether an advanced directive, DNH orders would be effective in reducing hospital/emergency department transfers,” said Taeko Nakashima, a visiting assistant professor in the department of Health Policy Management and Behavior at UAlbany’s School of Public Health. “The results show that for residents without DNH orders, the odds of being transferred to a hospital were significantly higher.”

“The findings suggest that residents’ end-of-life care decisions were respected and honored. Efforts should be made to encourage nursing home residents to complete DNH orders to promote integration of the resident’s values and goals in guiding care provision toward the end of life,” said Yuchi Young, UAlbany Associate Professor of Health Policy, Management and Behavior.

According to the findings, residents with DNH orders had significantly fewer unnecessary hospital stays and emergency department visits in their last 90 days of life than residents without them, the researchers reported. The orders also helped reduce hospital stays for residents with dementia.

Nakashima, who is also on the faculty of the Department of Economics at Rutgers University, authored the study with Young and Wan-Hsiang Hsu of the New York State Department of Health’s Bureau of Environmental and Occupational Epidemiology.

UAlbany’s School of Public Health, created through a memorandum of understanding between the University at Albany and the New York State Department of Health has advanced biomedical research, public health policy and program development, peer-reviewed scholarship, and teaching.  The School and NYSDOH work together to improve the health of the New York’s citizens by providing an academic focus to problems faced in health department practice settings.

Home to the largest concentration of individual health science-related entities in the Capital Region, the Health Sciences Campus is anchored by the University’s School of Public Health and Cancer Research Center with its Center for Functional Genomics. Other campus residents include organizations such as Regeneron, Albany Molecular Research, Taconic, and select research divisions of Albany Medical College and Albany College of Pharmacy and Health Sciences, as well as a dozen other area start-up and biomedical organizations.