If you, or a loved one is living in long-term care and doing your advance serious illness planning, here are some things to think about.
Is the Long-term Care home the best location?
Some people will develop a serious illness while residing in a long-term care home. Many patients view staying at their residence, rather than transferring to the hospital, as desirable.
Long-term care homes provide a variety of medical treatments to minimize the need to transfer to acute care hospitals. These treatments include oral antibiotics for infection, on site x-rays, and a number of other treatments.
These homes are also able to provide comfort and palliative care. These services support residents who wish not to be transferred, or have chosen to pass away in long-term care. However, there may be situations where a physician may recommend a transfer to acute care. A transfer may be recommended if an individual requires intravenous medications, more intensive monitoring, or surgery.
Transferring to acute care has some risks and benefits. It is important to discuss you or your loved one’s values and medical condition with the clinical team in order to understand what medical services can be provided. If a serious illness develops, it is important to understand the treatment options available.
Is transferring to hospital the right call?
Acute care hospitals can offer more aggressive and intensive care when managing serious illnesses. Thus, transferring may give a greater chance at surviving the serious illness. However, there are ‘downsides’ or ‘risks’ associated with transfer to acute care hospitals. The transfer itself may be uncomfortable, difficult, and distressing because of the unfamiliar setting of the hospital.
Compared to residents who stay at their home in long-term care, residents that go to hospital may develop additional complications. Confusion and worsening memory, falls, new wounds and infections, are a few examples. Often, residents don’t return to their ‘baseline’ condition after going to hospital.
Because of these risks, some people choose not to transfer and receive less aggressive care during times of serious illness. Long-term care homes can provide high quality palliative care. Residents and families are familiar with the local staff, and the local staff know the needs of the resident. Therefore, in some situations, remaining in long-term care could be better than transferring to hospital.
Remember, if you are making this decision on behalf of your loved one, please consider what your loved one would want if they knew of these risks, the alternative option of staying at home in long-term care, and their current medical condition.
If you are caring for a loved one, check out additional resources that we have:
