Heart Failure Among Older Adults in Skilled Nursing Facilities: More of a Dilemma Than Many Now Realize.
Nicole M OrrDaniel E FormanGiuseppe De MatteisGiovanni GambassiPublished in: Current geriatrics reports (2015)
Post-acute care, encompassing long-term care hospitals, home health, inpatient rehabilitation, and skilled nursing facilities, is increasingly employed as an integral part of management for more complicated patients, particularly as hospitals seek to maintain costs and decrease length of stay. Skilled nursing facilities (SNFs) in particular are progressively utilized for patients with complex medical processes, including today's growing population of older hospitalized heart failure (HF) patients who pose a prominent challenge due to their high risks of mortality, 30-day readmissions, and substantial aggregate cost burden to the healthcare system. Publications to date have largely grouped post-hospitalized HF patients together when reporting demographic or outcome data, without differentiating those at SNFs from those at traditional nursing homes or other post-acute care settings. SNF patients suffer distinctive vulnerabilities and needs, and understanding these distinctions has implications for determining goals of care. In this review we evaluate HF patients referred to SNFs, and discuss the characteristics, outcomes, and management challenges associated with this particular population.
Keyphrases
- healthcare
- heart failure
- end stage renal disease
- acute care
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- palliative care
- cardiovascular disease
- physical activity
- type diabetes
- risk assessment
- emergency department
- machine learning
- skeletal muscle
- magnetic resonance imaging
- metabolic syndrome
- acute heart failure
- computed tomography
- electronic health record
- magnetic resonance
- coronary artery disease
- left ventricular
- climate change
- health insurance
- long term care
- human health
- data analysis
- community dwelling
- insulin resistance
- chronic pain