Remaining in the Nursing Home Versus Transfer to Acute Care: Resident, Family, and Staff Preferences

Resident and family insistence on transfer is a major factor in the occurrence of potentially avoidable transfers from nursing homes (NHs) to acute care. The purpose of this study was to explore resident, family, and staff preferences regarding transfer to acute care. A sample of 271 NH residents, family members, staff, and medical providers were interviewed. Seventy-seven percent of residents reported that they had not given any thought to the question of whether they would want to be transferred to acute care. Family members wanted more information than residents, but more residents (39%) thought they should be fully involved in the transfer decision than their family members (12%) or staff (12%). Staff preferred keeping residents in the NH. Families were divided between transferring residents and having them remain in the NH. More residents indicated that their desire to transfer would depend on the severity of their condition and their prognosis. Ethnic group differences were noted. Results suggest that discussion of this issue should occur soon after admission and that differences in perspectives may be expected from those involved. [Journal of Gerontological Nursing, 40(10), 48–57.] Dr. Tappen is Professor and Christine E. Lynn Eminent Scholar, Ms. Elkins is doctoral candidate, Dr. Hain is Associate Professor, Ms. Moffa is Doctoral Candidate, and Ms. Sullivan is Doctoral Candidate, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida; and Ms. Worch is Doctoral Candidate, Department of Family Therapy, Nova Southeastern University, Davie, Florida. The authors have disclosed no potential conflicts of interest, financial or otherwise. This research was supported by a grant from the Patient Centered Outcomes Research Institute (343268-2 “Involving Nursing Home Residents and their Families in Hospital Transfer Decisions”). Address correspondence to Ruth M. Tappen, EdD, RN, FAAN, Professor, Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL, 33431; e-mail: rtappen@fau.edu. Received: May 01, 2014 Accepted: July 03, 2014 Posted Online: August 19, 2014