The family physician and nursing-home care.

Nursing home patinets are becoming more numerous and now form a part of most family physicians' practices. Physicians wishing to do more nursing home care require guideliness for preventing unnecessary nursing home admissions, for scheduling visits, and for making transfers to hospital. Multi-disciplinary conferences and good basic documentation are valuable in the nursing home. Therapy with medication may be a problem, especially if changes in compliance and independence as a therapeutic end-point are not borne in mind. Serious ethical questions arise routinely in the care of nursing home patients, and a scheme for addressing these is presented, together with some of its limitations. Contrary to the current common wisdom, nursing home care may be challenging and rewarding.