This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Time for Reappraisal in Long-term-Care Institutions

Donald J. Murphy, MD

JAMA. 1988;260(14):2098-2101.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CARDIOPULMONARY resuscitation (CPR) of elderly, chronically ill patients is an important, emotion-laden issue for many administrators, physicians, and nurses working in nursing homes and chronic-care hospitals. Resuscitations in these settings evoke thoughts and images that are not necessarily associated with resuscitations in a younger, healthier population. When an emphysematous nonagenarian lies on the floor, ashen, with a handful of nurses compressing his chest and breathing through his mouth, a sense of futility permeates the room. After each such episode in a long-term-care (LTC) facility, one wonders if indeed this effort is futile. And if it is, why do we do it?

Most of the literature on resuscitation focuses on policies and outcomes in acute-care hospitals. However, the dilemmas encountered in LTC institutions are also substantial. Beds in LTC facilities already outnumber acute-care hospital beds in the United States,¹ and the difference is expected to grow as the population ages. . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Medicine, Hebrew Rehabilitation Center for Aged, Beth Israel Hospital, and Harvard Medical School, Boston. Dr Murphy is now with the George Washington University Medical Center, Washington, DC.

Footnotes
Reprint requests to the ICU Research Unit, George Washington University Medical Center, 2300 K St NW, Washington, DC 20037.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?