Palliative Care in the Long-Term Care Setting

  • Mary Ersek
  • Justine S. Sefcik
  • David G. Stevenson
Part of the Aging Medicine book series (AGME)


Over 25 % of adults, age 65 and older, including 67 % of persons with advanced dementia, live their final days in nursing homes. Despite the billions of dollars spent on nursing home services, care in this setting is associated with poor symptom control, burdensome transitions, and low family satisfaction with care. Palliative care is one approach to enhancing care for nursing home residents with progressive, life-limiting illnesses. This chapter describes models of palliative care delivery in nursing homes including strengths and challenges with each model. We also recommend several policy changes that can advance the care of older adults living and dying in this setting.


Palliative Care Advance Care Planning Palliative Care Service Skilled Nurse Facility Hospice Care 
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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mary Ersek
    • 1
    • 2
  • Justine S. Sefcik
    • 3
  • David G. Stevenson
    • 4
  1. 1.National PROMISE Center, Philadelphia Veterans Affairs Medical CenterPhiladelphiaUSA
  2. 2.University of Pennsylvania School of NursingPhiladelphiaUSA
  3. 3.2012–2014 National Hartford Centers of Gerontological, Nursing Excellence Patricia G. Archbold ScholarUniversity of Pennsylvania School of NursingPhiladelphiaUSA
  4. 4.Department of Health PolicyVanderbilt University School of MedicineNashvilleUSA

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