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Invited Commentary
June 2015

Lower Extremity Revascularization in Nursing Home Residents: Surgery as Palliation

Author Affiliations
  • 1University of Rochester School of Medicine, Rochester, New York
JAMA Intern Med. 2015;175(6):957-958. doi:10.1001/jamainternmed.2015.32

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?

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    1 Comment for this article
    corrections needed
    Kathryn Locatell, MD | none
    There are two errors in this commentary. One, it's \"Minimum\" Data Set, not \"Minimal\" Data Set. The relevant article does reference the Minimum Data Set. I wonder if the author has ever reviewed the MDS of a nursing home resident. There is actually an assessment, albeit a limited one, within the MDS of preferred intensity of care in Section A.Two, the footnote is wrong here: \"A somewhat related study by Neuman et al\"; footnote 5 is the NEJM article, not the JAMA study which is footnote 6.