The number of older adults residing in long-term care facilities in the United States is increasing at an unprecedented rate; at present, there are approximately 1.5 million nursing home residents, and this number will double to 3 million by 2030.1 More than half will be older than 85 years. Most will be burdened by chronic illnesses, declining physical and cognitive function, and a short life expectancy. Internists and geriatricians will direct the bulk of their medical care. Clinical management is hindered by the relative lack of reliable clinical guidelines specifically directed at frail older adults who live in institutions. How do we decide on “right care” in such circumstances?
Hall WJ. Lower Extremity Revascularization in Nursing Home ResidentsSurgery as Palliation. JAMA Intern Med. 2015;175(6):957-958. doi:10.1001/jamainternmed.2015.32