Abstract
Nursing home (NH) residents account for over 2.2 million Emergency Department (ED) visits yearly; the majority are transported by Emergency Medical Services (EMS). The purpose of this study was to investigate how EMS providers respond to 911 calls when imminent death is from a chronic—non-acute condition. Surveys were conducted with 178 EMS providers and follow-up interviews with 43. Survey results indicated that 96% reported NH calls at least monthly - 48% on every shift; 58% report receiving at least monthly requests to transport an actively dying resident to an ED. Nearly half (46%) endorsed the need for interdisciplinary interventions between EMS, hospice, and NHs to address challenges. Interview themes illustrated contributing factors as: Limited staff training, experience; Dying-related fear, panic, distress; Staff shortages; and Organizational protocols promoting 911 calls. The findings illuminated the lack of comprehensive advance care planning for NH residents who are frail and approaching life’s end.