The extent of LST provided to residents who had been
transferred to hospitals appear to be of the same level as
that of the frail patients (those that had required assistance
in eating, toileting and other aspects of daily life for one
or more years) in a hospital survey [33]. The only exception
was more use of feeding tubes in the hospital survey,
38.4%, compared with 26.4% in this survey. This difference
is probably due to the fact that about half (47.5%) of the
frail patients in the hospital survey were in hospital chronic
care units where their use is much higher than in nursing
homes [34]. Unlike other LST procedures, feeding tubes
were more likely to have been placed before the resident
had been transferred to the hospital. In nursing homes, the
proportion of residents with feeding tubes would be lower
than in long-term care hospitals because, until recently,
only licensed nurses were allowed to provide suction that
might be needed for those having feeding tubes [35]. Our
study showed that such less use of feeding tubes would
reflect the preferences of the family and resident. Others
from Japan have noted that family members having direct
experiences, and physicians when given a choice for their
own use, tend not to prefer them [36,37].
The extent of LST provided to residents who had been
transferred to hospitals appear to be of the same level as
that of the frail patients (those that had required assistance
in eating, toileting and other aspects of daily life for one
or more years) in a hospital survey [33]. The only exception
was more use of feeding tubes in the hospital survey,
38.4%, compared with 26.4% in this survey. This difference
is probably due to the fact that about half (47.5%) of the
frail patients in the hospital survey were in hospital chronic
care units where their use is much higher than in nursing
homes [34]. Unlike other LST procedures, feeding tubes
were more likely to have been placed before the resident
had been transferred to the hospital. In nursing homes, the
proportion of residents with feeding tubes would be lower
than in long-term care hospitals because, until recently,
only licensed nurses were allowed to provide suction that
might be needed for those having feeding tubes [35]. Our
study showed that such less use of feeding tubes would
reflect the preferences of the family and resident. Others
from Japan have noted that family members having direct
experiences, and physicians when given a choice for their
own use, tend not to prefer them [36,37].
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