Joan Teno

Summary

Affiliation: Brown University
Country: USA

Publications

  1. pmc Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009
    Joan M Teno
    Warren Alpert Medical School of Brown University, 121 S Main St, Providence, RI 02912, USA
    JAMA 309:470-7. 2013
  2. pmc Does feeding tube insertion and its timing improve survival?
    Joan M Teno
    Center for Gerontology and Health Care Research, Warren Alpert School of Medicine, Brown University, Providence, RI 02912, USA
    J Am Geriatr Soc 60:1918-21. 2012
  3. pmc Feeding tubes and the prevention or healing of pressure ulcers
    Joan M Teno
    Center for Gerontology and Health Care Research, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
    Arch Intern Med 172:697-701. 2012
  4. doi request reprint It is "too late" or is it? Bereaved family member perceptions of hospice referral when their family member was on hospice for seven days or less
    Joan M Teno
    Warren Alpert School of Medicine at Brown University, Providence, RI, USA
    J Pain Symptom Manage 43:732-8. 2012
  5. pmc Churning: the association between health care transitions and feeding tube insertion for nursing home residents with advanced cognitive impairment
    Joan M Teno
    Center for Gerontology and Health Care Research, Department of Community Health, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA
    J Palliat Med 12:359-62. 2009
  6. doi request reprint Referring a patient and family to high-quality palliative care at the close of life: "We met a new personality... with this level of compassion and empathy"
    Joan M Teno
    Community Health and Medicine, Warren Alpert School of Medicine at Brown University, 2 Stimson Ave, Providence, RI 02912, USA
    JAMA 301:651-9. 2009
  7. ncbi request reprint Bereaved family member perceptions of quality of end-of-life care in U.S. regions with high and low usage of intensive care unit care
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown Medical School, Providence, Rhode Island 02912, USA
    J Am Geriatr Soc 53:1905-11. 2005
  8. ncbi request reprint Measuring end-of-life care outcomes retrospectively
    Joan M Teno
    Brown University and Brown Medical School, Providence, Rhode Island 02912, USA
    J Palliat Med 8:S42-9. 2005
  9. pmc Cancer patient assessment and reports of excellence: reliability and validity of advanced cancer patient perceptions of the quality of care
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown University School of Medicine, Providence, RI 02912, USA
    J Clin Oncol 27:1621-6. 2009
  10. pmc "You can't always get what you want"--or can you?
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown University and Brown Medical School, Providence, RI, USA
    CMAJ 174:643-4. 2006

Detail Information

Publications57

  1. pmc Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009
    Joan M Teno
    Warren Alpert Medical School of Brown University, 121 S Main St, Providence, RI 02912, USA
    JAMA 309:470-7. 2013
    ..A recent Centers for Disease Control and Prevention report found that more persons die at home. This has been cited as evidence that persons dying in the United States are using more supportive care...
  2. pmc Does feeding tube insertion and its timing improve survival?
    Joan M Teno
    Center for Gerontology and Health Care Research, Warren Alpert School of Medicine, Brown University, Providence, RI 02912, USA
    J Am Geriatr Soc 60:1918-21. 2012
    ..To examine survival with and without a percutaneous endoscopic gastrostomy (PEG) feeding tube using rigorous methods to account for selection bias and to examine whether the timing of feeding tube insertion affected survival...
  3. pmc Feeding tubes and the prevention or healing of pressure ulcers
    Joan M Teno
    Center for Gerontology and Health Care Research, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
    Arch Intern Med 172:697-701. 2012
    ..Using national data, we set out to determine whether percutaneous endoscopic gastrostomy (PEG) tubes prevent or help heal pressure ulcers in nursing home (NH) residents with advanced cognitive impairment (ACI)...
  4. doi request reprint It is "too late" or is it? Bereaved family member perceptions of hospice referral when their family member was on hospice for seven days or less
    Joan M Teno
    Warren Alpert School of Medicine at Brown University, Providence, RI, USA
    J Pain Symptom Manage 43:732-8. 2012
    ..Many family members of patients enrolled in hospice for less than seven days state that the hospice referral was made "at the right time."..
  5. pmc Churning: the association between health care transitions and feeding tube insertion for nursing home residents with advanced cognitive impairment
    Joan M Teno
    Center for Gerontology and Health Care Research, Department of Community Health, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA
    J Palliat Med 12:359-62. 2009
    ..The goal of this study was to examine whether regions with higher rates of health care transitions at the end of life are more likely to use feeding tubes in patients with severe cognitive impairment...
  6. doi request reprint Referring a patient and family to high-quality palliative care at the close of life: "We met a new personality... with this level of compassion and empathy"
    Joan M Teno
    Community Health and Medicine, Warren Alpert School of Medicine at Brown University, 2 Stimson Ave, Providence, RI 02912, USA
    JAMA 301:651-9. 2009
    ....
  7. ncbi request reprint Bereaved family member perceptions of quality of end-of-life care in U.S. regions with high and low usage of intensive care unit care
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown Medical School, Providence, Rhode Island 02912, USA
    J Am Geriatr Soc 53:1905-11. 2005
    ..To compare the quality of end-of-life care of persons dying in regions of differing practice intensity...
  8. ncbi request reprint Measuring end-of-life care outcomes retrospectively
    Joan M Teno
    Brown University and Brown Medical School, Providence, Rhode Island 02912, USA
    J Palliat Med 8:S42-9. 2005
    ....
  9. pmc Cancer patient assessment and reports of excellence: reliability and validity of advanced cancer patient perceptions of the quality of care
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown University School of Medicine, Providence, RI 02912, USA
    J Clin Oncol 27:1621-6. 2009
    ..This article describes the validation of new measures of the quality of cancer care at the time of diagnosis and treatment for advanced cancer with life-limiting prognosis...
  10. pmc "You can't always get what you want"--or can you?
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown University and Brown Medical School, Providence, RI, USA
    CMAJ 174:643-4. 2006
  11. pmc Do financial incentives of introducing case mix reimbursement increase feeding tube use in nursing home residents?
    Joan M Teno
    Center for Gerontology and Health Care Research, Department of Community Health, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
    J Am Geriatr Soc 56:887-90. 2008
    ..To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents...
  12. ncbi request reprint Timing of referral to hospice and quality of care: length of stay and bereaved family members' perceptions of the timing of hospice referral
    Joan M Teno
    The Warren Alpert Medical School of Medicine at Brown University, Providence, Rhode Island 20912, USA
    J Pain Symptom Manage 34:120-5. 2007
    ..This perception varies substantially among the participating hospice programs. Future research is needed to understand this variation and how hospice programs are delivering high quality of care despite short length of stay...
  13. pmc Hospital characteristics associated with feeding tube placement in nursing home residents with advanced cognitive impairment
    Joan M Teno
    Center for Gerontology and Health Care Research, Warren Alpert School of Medicine, Brown University, 121 S Main St, Providence, RI 02912, USA
    JAMA 303:544-50. 2010
    ..Tube-feeding is of questionable benefit for nursing home residents with advanced dementia. Approximately two-thirds of US nursing home residents who are tube fed had their feeding tube inserted during an acute care hospitalization...
  14. ncbi request reprint Association between advance directives and quality of end-of-life care: a national study
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown Medical School, Providence, Rhode Island, USA
    J Am Geriatr Soc 55:189-94. 2007
    ..To examine the role of advance directives (ADs) 10 years after the Patient Self-Determination Act...
  15. ncbi request reprint Dying trajectory in the last year of life: does cancer trajectory fit other diseases?
    J M Teno
    Department of Community Health, Center for Gerontology and Health Care Research, Brown University School of Medicine, Providence, Rhode Island, USA
    J Palliat Med 4:457-64. 2001
    ..To examine differences in the pattern of functional decline among persons dying of cancer and other leading noncancer causes of death...
  16. pmc Decision-making and outcomes of feeding tube insertion: a five-state study
    Joan M Teno
    Health Services, Policy, and Practice, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
    J Am Geriatr Soc 59:881-6. 2011
    ..To examine family member's perceptions of decision-making and outcomes of feeding tubes...
  17. pmc Development of a brief survey to measure nursing home residents' perceptions of pain management
    Joan M Teno
    The Warren Alpert Medical School, Brown University, Providence, Rhode Island 02912, USA
    J Pain Symptom Manage 36:572-83. 2008
    ..Although there is concern with the low internal consistency, RAPM demonstrates both criterion and construct validity that suggests its potential use in quality improvement efforts...
  18. ncbi request reprint Daily pain that was excruciating at some time in the previous week: prevalence, characteristics, and outcomes in nursing home residents
    Joan M Teno
    Department of Community Health, Brown Medical School, Providence, Rhode Island, New York, USA
    J Am Geriatr Soc 52:762-7. 2004
    ..To examine the prevalence, correlates, and consequences of nursing home (NH) staff reports of "excruciating" level of pain at some time in the previous week in persons with daily pain reported on the Minimum Data Set (MDS)...
  19. pmc Terminal hospitalizations of nursing home residents: does facility increasing the rate of do not resuscitate orders reduce them?
    Joan M Teno
    The Warren Albert Medical School of Brown University, Providence, Rhode Island, RI 02912, USA
    J Pain Symptom Manage 41:1040-7. 2011
    ..Terminal hospitalizations are costly and often avoidable with appropriate advance care planning...
  20. ncbi request reprint Family perspectives on end-of-life care at the last place of care
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown Medical School, Providence, RI, USA
    JAMA 291:88-93. 2004
    ..Over the past century, nursing homes and hospitals increasingly have become the site of death, yet no national studies have examined the adequacy or quality of end-of-life care in institutional settings compared with deaths at home...
  21. pmc Does hospice improve quality of care for persons dying from dementia?
    Joan M Teno
    Department of Community Health, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
    J Am Geriatr Soc 59:1531-6. 2011
    ..To examine the effectiveness of hospice services for persons dying from dementia from the perspective of bereaved family members...
  22. ncbi request reprint Family perspectives on end-of-life care experiences in nursing homes
    Terrie Wetle
    Center for Gerontology and Health Care Research, Brown University, Providence, RI 02912, USA
    Gerontologist 45:642-50. 2005
    ..The purpose of this study is to expand knowledge regarding end-of-life care received in nursing homes through the use of narrative interviews with family members close to the decedents...
  23. doi request reprint Vigilant at the end of life: family advocacy in the nursing home
    Renee R Shield
    Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island 02912, USA
    J Palliat Med 13:573-9. 2010
    ..Increasing numbers of Americans die in nursing homes. Little is known about the roles and experiences of family members of persons who die in nursing homes...
  24. ncbi request reprint Physicians "missing in action": family perspectives on physician and staffing problems in end-of-life care in the nursing home
    Renee R Shield
    Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island 02912, USA
    J Am Geriatr Soc 53:1651-7. 2005
    ..To understand the roles of physicians and staff in nursing homes in relation to end-of-life care through narrative interviews with family members close to a decedent...
  25. ncbi request reprint Where people die: a multilevel approach to understanding influences on site of death in America
    Andrea Gruneir
    Brown University, USA
    Med Care Res Rev 64:351-78. 2007
    ..These results reinforce the importance of both social and structural characteristics in shaping the end-of-life experience...
  26. doi request reprint Home care in the last year of life: family member perceptions of unmet need associated with last place of care
    Aman Nanda
    Division of Geriatrics, Rhode Island Hospital, Brown Medical School, 593 Eddy Street, Providence, RI 02903, USA
    J Am Med Dir Assoc 11:21-5. 2010
    ..To examine the association of family members' perception about the adequacy of home health services at the last place of care before death...
  27. ncbi request reprint Preliminary derivation of a Nursing Home Confusion Assessment Method based on data from the Minimum Data Set
    David Dosa
    Department of Medicine, Brown University, Providence, Rhode Island, USA
    J Am Geriatr Soc 55:1099-105. 2007
    ....
  28. ncbi request reprint Hospice enrollment and pain assessment and management in nursing homes
    Susan C Miller
    Department of Community Health, Center for Gerontology and Health Care Research, Brown University School of Medicine, 23 Stimson Street, Providence, RI 02912, USA
    J Pain Symptom Manage 26:791-9. 2003
    ..7; 95% CI 0.9, 7.7; P=0.07). Study results suggest that hospice enrollment improves pain assessment and management for nursing home residents; they also document the need for continued improvement of pain management in nursing homes...
  29. ncbi request reprint Feeding tubes for nursing home residents with advanced dementia: how to approach feeding tube decisions
    Ana Tuya
    Division of Geriatrics, The Warren Alpert Medical School of Brown University, USA
    Med Health R I 91:33-4. 2008
  30. doi request reprint Advancing the science of hospice care: Coalition of Hospices Organized to Investigate Comparative Effectiveness
    David J Casarett
    Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
    Curr Opin Support Palliat Care 6:459-64. 2012
    ..Moreover, they cannot examine the implementation of therapies in real-world settings. Therefore, there is a need for novel, complementary approaches to research in this unique population...
  31. ncbi request reprint Patient-focused, family-centered end-of-life medical care: views of the guidelines and bereaved family members
    J M Teno
    Center for Gerontology and Health Care Research, Brown University, Providence, RI 02912, USA
    J Pain Symptom Manage 22:738-51. 2001
    ..A new survey instrument provides a way to incorporate the perspectives of bereaved family members in measuring the quality of end-of-life care...
  32. doi request reprint Perceptions of cost constraints, resource limitations, and rationing in United States intensive care units: results of a national survey
    Nicholas S Ward
    Division of Pulmonary Critical Care, Brown Medical School, Providence, RI, USA
    Crit Care Med 36:471-6. 2008
    ..To examine cost constraints, resource limitations, and rationing within U.S. intensive care units (ICUs) as perceived by ICU clinicians and the roles of ICU physician and nurse directors in resource allocation decisions...
  33. doi request reprint Hospice care for patients with dementia: does volume make a difference?
    Susan C Miller
    Center for Gerontology and Health Care Research, Department of Community Health, The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
    J Pain Symptom Manage 35:283-91. 2008
    ..Further study is needed to understand the nonintuitive negative association between higher volume and lower satisfaction. This study emphasizes the need for examination of quality outcomes by profit status...
  34. doi request reprint Bereaved family members' evaluation of hospice care: what factors influence overall satisfaction with services?
    Ramona L Rhodes
    The Warren Alpert Medical School of Brown University, Brown University, Providence, RI 02912, USA
    J Pain Symptom Manage 35:365-71. 2008
    ..02, CI=1.92-2.13). These four key processes of care appear to significantly influence an "excellent" rating of overall satisfaction with hospice care...
  35. ncbi request reprint Now is the time to embrace nursing homes as a place of care for dying persons
    Joan M Teno
    J Palliat Med 6:293-6. 2003
  36. pmc Hispanic language version of the family evaluation of hospice care
    Jason Portenoy
    J Pain Symptom Manage 34:459-61. 2007
  37. ncbi request reprint African American bereaved family members' perceptions of the quality of hospice care: lessened disparities, but opportunities to improve remain
    Ramona L Rhodes
    Center for Gerontology and Health Care Research, Brown Medical School, Providence, RI 02912, USA
    J Pain Symptom Manage 34:472-9. 2007
    ....
  38. ncbi request reprint Clinical and organizational factors associated with feeding tube use among nursing home residents with advanced cognitive impairment
    Susan L Mitchell
    Hebrew Rehabilitation Center for Aged Research and Training Institute, Department of Medicine, Beth Israel Deaconess Medical Center, and Division on Aging, Harvard Medical School, Boston, MA 02131, USA
    JAMA 290:73-80. 2003
    ..Empiric data and expert opinion suggest that use of feeding tubes is not beneficial for older persons with advanced dementia. Previous research has shown a 10-fold variation in this practice across the United States...
  39. ncbi request reprint Use of feeding tubes in nursing home residents with severe cognitive impairment
    Joan M Teno
    JAMA 287:3211-2. 2002
  40. pmc Driven to tiers: socioeconomic and racial disparities in the quality of nursing home care
    Vincent Mor
    Brown University, Providence, RI, USA
    Milbank Q 82:227-56. 2004
    ..This article recommends a proactive policy stance to mitigate these consequences of quality competition...
  41. ncbi request reprint Hospice and palliative care in nursing homes
    Susan C Miller
    Center for Gerontology and Health Care Research, Brown University School of Medicine, 2 Stimson Street, Providence, RI 02912, USA
    Clin Geriatr Med 20:717-34, vii. 2004
    ..It is suggested that a stronger physician presence and oversight of physicians knowledgeable in palliative care in nursing homes are needed to improve the quality of end-of-life care in nursing homes...
  42. ncbi request reprint Ameliorating pain in nursing homes: a collaborative quality-improvement project
    Rosa R Baier
    Department of Community Health, Brown University, Providence, Rhode Island, USA
    J Am Geriatr Soc 52:1988-95. 2004
    ..To evaluate a multifaceted intervention to improve pain-management processes of care and outcomes in nursing homes...
  43. ncbi request reprint A national study of the location of death for older persons with dementia
    Susan L Mitchell
    Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston, Massachusetts 02131, USA
    J Am Geriatr Soc 53:299-305. 2005
    ..To describe where older Americans with dementia die and to compare the state health system factors related to the location of dementia-related deaths with those of cancer and all other conditions in this population...
  44. ncbi request reprint Medical care inconsistent with patients' treatment goals: association with 1-year Medicare resource use and survival
    Joan M Teno
    Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island, USA
    J Am Geriatr Soc 50:496-500. 2002
    ..To describe how frequently seriously ill persons perceive that the care they receive is inconsistent with treatment preferences and the effect on 1-year resource utilization...
  45. ncbi request reprint Palliative care needs of cancer patients in U.S. nursing homes
    Vanessa M P Johnson
    Oncology and Hematology Associates, New London, Connecticut, USA
    J Palliat Med 8:273-9. 2005
    ..Increasingly, nursing homes are the place of care for older Americans with cancer. Yet, few studies has characterized the quality of care for this growing population...
  46. ncbi request reprint Rules to use and rules to lose for pain management in the long-term care setting
    Joan M Teno
    Brown Medical School, Providence, RI 02912, USA
    Med Health R I 88:110-4. 2005
  47. ncbi request reprint End-of-life care in black and white: race matters for medical care of dying patients and their families
    Lisa C Welch
    Department of Community Health, Brown Medical School, Providence, Rhode Island, USA
    J Am Geriatr Soc 53:1145-53. 2005
    ..To compare the end-of-life medical care experienced by African-American and white decedents and their families...
  48. ncbi request reprint Late referral to hospice and bereaved family member perception of quality of end-of-life care
    Erica R Schockett
    Center for Gerontology and Health Care Research, and Department of Community Health, Brown Medical School, Providence, Rhode Island, USA
    J Pain Symptom Manage 30:400-7. 2005
    ..These results indicate a need for improved services for shorter-stay hospice patients/families and for physicians to help facilitate earlier hospice admission...
  49. ncbi request reprint Access to hospice for African Americans: are they informed about the option of hospice?
    Ramona L Rhodes
    Center for Gerontology and Health Care Research, Brown University, Providence, 02912, USA
    J Palliat Med 9:268-72. 2006
    ..To examine whether African Americans are informed about hospice services, and to examine demographic or disease factors that may influence receipt of information about hospice...
  50. ncbi request reprint Transitions of care and changes in distressing pain
    Peter C Trask
    Centers for Behavioral and Preventive Medicine, Brown University Medical School The Miriam Hospital, Providence, Rhode Island 02903, USA
    J Pain Symptom Manage 32:104-9. 2006
    ..Increased attention is needed not only on how to adequately manage pain and pain-related distress but also on how to improve pain reduction measures in transitions between health care settings at the end of life...
  51. pmc Advanced dementia research in the nursing home: the CASCADE study
    Susan L Mitchell
    Hebrew Senior Life Institute for Aging Research, Department of Medicine of Beth Israel Deaconess Medical Center, Boston, MA, USA
    Alzheimer Dis Assoc Disord 20:166-75. 2006
    ..The CASCADE experience establishes the feasibility of conducting rigorous, multisite dementia NH research, and the described methodology serves as a detailed reference for subsequent CASCADE publications as results from the study emerge...
  52. ncbi request reprint Decisions to forgo hospitalization in advanced dementia: a nationwide study
    Susan L Mitchell
    Hebrew SeniorLife, Institute for Aging Research and Beth Israel Deaconess Medical Center, Boston, Massachusetts 02131, USA
    J Am Geriatr Soc 55:432-8. 2007
    ..To examine the prevalence and factors associated with decisions to forgo hospitalization in nursing home (NH) residents with advanced dementia...
  53. ncbi request reprint Hospice care for patients with dementia
    Susan L Mitchell
    Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
    J Pain Symptom Manage 34:7-16. 2007
    ..These data suggest that the evaluation of hospice care for older patients is generally high, and does not vary with respect to terminal diagnoses...
  54. ncbi request reprint Factors associated with site of death: a national study of where people die
    Sherry Weitzen
    Center for Gerontology and Health Services Research, Providence, RI 02912, USA
    Med Care 41:323-35. 2003
    ..Recent public attention has focused on quality of care for the dying. Where one dies is an important individual and public health concern...
  55. ncbi request reprint Do-not-resuscitate orders and hospitalization of nursing home residents: trumping, neglect, or shared decision-making at the eleventh hour
    Joan M Teno
    J Am Geriatr Soc 52:159-60. 2004
  56. ncbi request reprint Resurrecting treatment histories of dead patients
    Joan M Teno
    JAMA 293:1591; author reply 1592. 2005
  57. ncbi request reprint Palliative care teams: self-reflection - past, present, and future
    Joan M Teno
    J Pain Symptom Manage 23:94-5. 2002

Research Grants12

  1. Feeding Tube Use Among Persons with Advanced Dementia
    Joan Teno; Fiscal Year: 2007
    ..Knowledge gained will be used to inform public policy and formulate facility interventions to ensure that FT insertion in persons with severe cognitive impairment is ethically appropriate. ..
  2. Multifaceted Interventions to Ameliorate Pain/Symptoms
    Joan Teno; Fiscal Year: 2005
    ....
  3. Cancer Assessments and Reports of End-of-Life Treatment
    Joan Teno; Fiscal Year: 2005
    ..Such tools will allow institutions to measure whether cancer care is meeting patient and family members' needs and expectations. ..
  4. RESIDENT ASSESSMENT OF PAIN MANAGEMENT (RAPM)
    Joan Teno; Fiscal Year: 2001
    ..abstract_text> ..
  5. Family Evaluation of Hospice Care
    Joan M Teno; Fiscal Year: 2010
    ..This grant will create two surveys and modify the core surveys that will help hospices in monitoring and improving their quality of care. ..