Finding the right level of posthospital care:We didn't realize there was any other option for him

Robert L Kane

Research output: Contribution to journalArticle

Abstract

Many families considering posthospital care options are ill-prepared and in need of guidance. They may not know the range of available options, the relative benefits of each, or have considered their therapeutic goals. Physicians should be informants, advocates, and facilitators of this big leap for their patients. Making a good long-term care decision requires information and structure, but such decisions are often made under great time pressure as part of a hospital discharge. Professional intervention and guidance by an informed but disinterested facilitator may be needed, but hospital discharge planners may not be well suited for this role because their mandate is a rapid discharge. Physicians have 2 crucial roles in these transitions: to ensure the seamless delivery of primary care and to advocate for and facilitate, however possible, better decision making. Physicians need at least a rudimentary knowledge of the array of options and the implications of each. Even if the physician cannot serve as the planning facilitator, the physician should ensure that this task is done well. This review describes the range of options and the implications of each option for long-term care in the United States. It suggests the need for evaluating each patient's care goals, family circumstances and resources, and clinical status to determine if more aggressive medical care might improve an individual's clinical trajectory.
Original languageEnglish (US)
Pages (from-to)284-576
Number of pages293
JournalJAMA
Volume305
Issue number3
StatePublished - 2011

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Physicians
Long-Term Care
Primary Health Care
Decision Making
Patient Care
Therapeutics

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Finding the right level of posthospital care:We didn't realize there was any other option for him. / Kane, Robert L.

In: JAMA, Vol. 305, No. 3, 2011, p. 284-576.

Research output: Contribution to journalArticle

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