The chief of the leading long-term care association is slamming a new study on high-intensity rehab performed on nursing home residents at the end of their life.
In an op-ed to the Hill political newspaper Thursday, Mark Parkinson, president and CEO of the American Health Care Association, urged the public not to rush to any conclusions from the Journal of the American Medical Directors Association study published earlier this month. The controversial study out of University of Rochester Medical Center indicated New York state nursing homes have increasingly pushed dying patients into unnecessary and potentially harmful high-intensity rehab.
“Using the JAMDA study to make broad generalizations about therapy for nursing home residents is a mistake,” Parkinson wrote, noting that only about 2% of patients included in the analysis actually received what the authors deemed excessive therapy. “The authors acknowledge they did nothing to evaluate care goals or potential benefits from the therapy that was provided. I have seen firsthand residents in nursing homes that have benefited from therapy at all stages of life.”
End-of-life care is a nuanced practice that must answer to medical, theological and ethical questions, Parkinson wrote. Decisions are made on an individualized basis, but providers do not possess a “crystal ball” around how close to death residents are, he added.
“Instead of speculating, we should rely on the real doctors who know the resident and have ordered therapy. Caregivers and physicians are not thinking about studies that show nursing homes should deliver more or less therapy. They are thinking about what’s best for their residents,” Parkinson wrote.
