The Quality of Advanced Dementia Care in the Nursing Home
Medical CarePublished 13 September 2012Open access
Rebecca Orfaly Cadigan, David C. Grabowski, Jane L. Givens, Susan L. Mitchell
Citations58
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TL;DR
Residence in an SCU is associated with some, but not all, markers of better quality end-of-life care among nursing home residents with advanced dementia.
Abstract
Residence in an SCU is associated with some, but not all, markers of better quality end-of-life care among nursing home residents with advanced dementia.
Keywords
MedicineHealth Professions
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