Tens of thousands of cancer patients, representing 10% to 15% of nursing home residents, are admitted to nursing facilities like the senior living in California every year. Another major number lose all independence at home when family caregivers become exhausted and quit providing care due to the mental and physical burdens of care giving. Yet many with the worst cancers—such as pancreatic cancer or breast cancer for which chemotherapy is used as a treatment method–can often be cared for in comfort and dignity at home or in a hospice program rather than in a hospital.
For many patients being near their loved ones can improve survival outcomes and reduce pain and other negative effects of treatment on quality of life; however the palliative care experts agree with recent research that suggests that approximately one third or more (depending on the type of cancer) of patients could be safely and effectively managed as outpatients by a team of doctors and/or nurses who are experts in managing pain and other symptoms while dealing with the complex goals of a patient’s palliation plan developed by the patient’s primary oncologist.
. Nursing homes have come under scrutiny for the quality of comfort care they provide. In fact Medicare expects nursing homes to improve palliative and supportive services in coming years as part of the Star quality ratings program that rewards good quality of care and encourages poor performing hospitals to improve their scores in order to stay in business and attract funding and earn profits for their shareholders from for-profit healthcare enterprises in the United States.
Cancer patients are admitted to nursing homes for a variety of reasons, terminal care being perhaps the best studied. As many as one quarter of all admissions may result from complications of cancer treatment such as cachexia – weight loss secondary to wasting syndrome brought on by anorexia resulting from adverse effects of cancer drugs like steroids.
Another significant reason is simply that a cancer diagnosis is the sign that time is growing short to live a prolonged existence in the absence of new medical interventions. In recent years mesothelioma has emerged as a major cause of admission to US skilled nursing facilities and while it is not common for a lung cancer patient to enter a hospital as a treatment option for being homebound breathing issues they are most often caused by pneumonia as a result of poorly controlled symptoms resulting in hospitalization.