Scenario 4: Transferring to hospital

My wife has been sent from the nursing home to the hospital for the fourth time in six months. Is this really the best thing for her?

  • Decisions about sending frail older people and people with end-stage dementia to hospital can be complex and stressful for family members.
  • In many cases, it is necessary to go to hospital – especially if there is a single problem that will respond to treatment, such as a hip fracture or an acute infection.
  • In many other cases, it may not be in the best interests of the person to be sent to hospital – especially if there are problems associated with the gradual dying process that will not readily respond to treatment.
  • A large misconception is that the “best” health care is always provided in a hospital. This may lead carers to send a loved one from a nursing home to a hospital – even though it may not be in the person’s best interests.
  • It is not always possible to make an ideal decision. Sometimes a person is transferred to hospital because the nursing home does not have enough staff to provide nursing care, or there is limited access to a GP to provide medical care.
  • When considering whether a loved one should be transferred to hospital, it is worth asking their GP or the nursing home staff the following questions:
    • What exactly is the reason they are being transferred?
    • What treatments are likely to be given?
    • What are the benefits and risks of these treatments?
    • Are the treatments likely to reduce the person’s quality of life?
    • Can they receive treatments in the nursing home that will provide similar benefits and fewer risks?
    • Can extra support be found (from family, facility staff or outside agencies) to allow the person to be cared for appropriately in the nursing home?
    • Will the person get appropriate medical support in the nursing home?
    • What would the person themselves have wanted to do in these circumstances?