In the report, experts offer several recommendations to improve end-of-life care in nursing homes. One of the most critical: Improve government reimbursement rates.
"Listening to families' compelling stories of end-of-life care, it is clear that nursing homes need more staff and better training for that staff," said Terrie Wetle, associate dean of medicine for public health and public policy and professor of community health at Brown Medical School.
"Workers also need to be better paid," Wetle said. "Even at the best facilities, aides are frequently offered wages that are about what they'd make at McDonald's. But many homes simply don't have the money to provide the level of care and support that the dying need."
The report was published by the AARP Public Policy Institute, which fosters research and analysis on policy issues of importance to mid-life and older Americans. With 22 percent of all U.S. deaths taking place in nursing homes, and with scant research on their experiences, AARP commissioned members of Brown's Center for Gerontology and Health Care Research to gather and analyze data.
"This research represents a rare collaboration of a large-scale survey that documented the extent of problems in providing end-of-life care in nursing homes and in-depth interviews in which surviving family members movingly describe the problems they faced," said John Rother, AARP director of public policy and strategy. "Their stories make a powerful case for changing the way we provide care at the end of life in nursing homes and other care facilities."
The research team included Wetle, Joan Teno, Renee Shield, Lisa Welch and Susan Miller, who conduct research in Brown's Cen
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