LOS ANGELES: Skilled nursing home operators are kidding themselves if they believe they can deliver the highest quality person-centered end of life care in a skilled nursing home setting.
The central premise of the medical/clinician/nurse taking a back seat whilst the family, friends, neighbors and contacts of the recipient have primacy is anathema to skilled nursing home operators.
The setting is wrong, the culture too brutal, the understanding too shallow, the education too certain, and there is an abiding discomfort with the subtle inference that the skilled nursing home raison d’etre is being challenged.
The new model bypasses the skilled nursing home, but doesn’t necessarily exclude the skilled nursing home from participation…