ABSTRACT
More than 30% of people living in nursing homes in the United States die there or within a short time after transfer to an acute care facility, highlighting the need for an increased focus on delivery of palliative care services (Center for Disease Control and Prevention 2002). A signišcant part of this care requires consideration of the resident’s preferences for life-sustaining treatment. One manner in which these preferences are communicated is through advance directives (ADs) executed by the residents. Although a variety of treatments may be addressed, artišcial nutrition (AN) has attracted signišcant attention. In the recent case of Terri Schiavo, a young American nursing home resident in a persistent vegetative state receiving AN, commentary spread across the world, including a papal address. In light of society’s continuing struggle with this life-sustaining treatment, this chapter addresses nursing home care, ADs, and AN for those at the end-of-life.
