Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice

Palliative care (PC) is vital for nursing home (NH) residents to ensure that people living with serious illness receive the best possible quality of life and care. Despite high symptom burden reported by most NH residents, their families, and staff, PC remains underutilized.1-4 Multifaceted barriers contribute to this underuse, including vague and ill-defined referral criteria.5-7One solution to improve timely identification of residents with unmet PC needs is the use of a PC screening tool. Despite common use in other healthcare settings, there is a lack of validated tools designed for NHs.5 A challenge in creating these tools stems from the absence of evidence-based referral criteria. Establishing such a criteria is critical to ensuring that NH residents receive appropriate and timely PC. To address this gap, this study examined existing referral practices, explored recommendations for ideal criteria, and integrated both to create a framework for PC referral in NHs.