Defining Life-Limiting Illness in the Nursing Home Population: Identifying a Population to Benefit from Palliative Care Services

Patients with life-limiting conditions often benefit from palliative care to improve quality of life. There is no consensus definition of the term "life-limiting illness" for the nursing home population. The objective of this paper was to provide a framework to define life-limiting illness in the nursing home population using a narrative review. PubMed and GoogleScholar were searched for terms to define: "life-limiting illness," "serious illness," and "end-of-life." Based on peer-reviewed literature, we operationalized the term "life-limiting illness" in the context of the nursing home population into five domains: (1) prognosis-based definitions (i.e. <6 months), (2) mortality risk-based (i.e. high risk vs low risk), (3) healthcare service-based (i.e. receipt of palliative care consult), (4) comorbidity index-based (e.g. the Veteran's Health Association Palliative Care Index), and (5) composite definition (i.e. comorbidity and caregiver burden).