Objective: To evaluate the impact of the policy to encourage nursing homes to provide
end-of-life care by comparing facility and resident variables associated with dying within
the nursing home and not in hospitals, and by comparing life sustaining treatment (LST)
respectively provided.
Method: Questionnaires mailed to an 11% random sample of 653 nursing homes in 2009.
Facility characteristics from 371 nursing homes (57%) and resident characteristics of the
1158 who had been discharged due to death were obtained from 241 facilities (37%).
Results: Facility characteristics related to dying in nursing homes were their policy of providing
end-of-life care and physicians being based in home care supporting clinics. Resident
characteristics related were not having pneumonia as the cause of death, the family’s preference
of the nursing home as the site of death and agreement within the family. Preferences
on the use of LST were adhered more in residents who had died in nursing homes.
Conclusion: Although the percentage of residents dying within the facility has increased,
the nursing home as a site of death still composes only 3.2% of the total. To increase the
latter, nursing homes should refocus their function to providing end-of-life care to those
not preferring aggressive treatment.