دورية أكاديمية
What care do people with dementia receive at the end of life? Lessons from a retrospective clinical audit of deaths in hospital and other settings.
| العنوان: | What care do people with dementia receive at the end of life? Lessons from a retrospective clinical audit of deaths in hospital and other settings. |
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| المؤلفون: | Triandafilidis Z; Central Coast Research Institute (CCRI) for Integrated Care, Gosford, NSW, Australia. zoi.triandafilidis@health.nsw.gov.au.; The University of Newcastle, Gosford, NSW, Australia. zoi.triandafilidis@health.nsw.gov.au., Carr S; Central Coast Local Health District, Gosford, NSW, Australia., Davis D; Central Coast Local Health District, Gosford, NSW, Australia., Chiu S; Hunter Medical Research Institute, Newcastle, NSW, Australia., Leigh L; Hunter Medical Research Institute, Newcastle, NSW, Australia., Jeong S; Central Coast Local Health District, Gosford, NSW, Australia.; The University of Sydney, Sydney, NSW, Australia., Wong D; The University of Newcastle, Gosford, NSW, Australia.; Central Coast Local Health District, Gosford, NSW, Australia., Hensby J; Central Coast Local Health District, Gosford, NSW, Australia., Lewis S; Central Coast Research Institute (CCRI) for Integrated Care, Gosford, NSW, Australia.; The University of Newcastle, Gosford, NSW, Australia., Attia J; The University of Newcastle, Gosford, NSW, Australia.; Hunter Medical Research Institute, Newcastle, NSW, Australia., Goodwin N; Central Coast Research Institute (CCRI) for Integrated Care, Gosford, NSW, Australia.; The University of Newcastle, Gosford, NSW, Australia.; Central Coast Local Health District, Gosford, NSW, Australia. |
| المصدر: | BMC geriatrics [BMC Geriatr] 2024 Jan 09; Vol. 24 (1), pp. 40. Date of Electronic Publication: 2024 Jan 09. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968548 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2318 (Electronic) Linking ISSN: 14712318 NLM ISO Abbreviation: BMC Geriatr Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001]- |
| مواضيع طبية MeSH: | Clinical Audit* , Dementia*/diagnosis , Dementia*/therapy , Terminal Care*, Humans ; Hospitals ; Retrospective Studies |
| مستخلص: | Background: The need for better end-of-life care for people with dementia has been acknowledged. Existing literature suggests that people dying with dementia have less access to palliative care, yet little is known about the care provided to people with dementia at the end of life. This study aimed to establish evidence related to end-of-life care for people dying with dementia in hospital compared to other settings. Methods: A retrospective clinical audit of people who had a diagnosis of dementia and had accessed services within a local health district, who died between 2015 and 2019, was conducted. A total of 705 people were identified, and a subset of 299 people randomly selected for manual audit. Chi-square p-values were used to compare the place of death, and a t-test or non-parametric test was used to assess the significance of the difference, as appropriate. Measures of functional decline within one month of death were assessed using mixed effects logistic regression models. Results: The characteristics of people differed by place of death, with people who died in hospital more likely to be living at home and to not have a spouse. Less than 1 in 5 people had advance care directives or plans. Many were still being actively treated at the time of death: almost half of people who died in hospital had an investigation in their final 72 hours, less than half of people were coded as receiving palliative care at death, and more than 2 in 3 people did not get access to specialist palliative care. Declining function was associated with the terminal phase. Conclusion: This study provides novel insights for those providing end-of-life care for people with dementia. Healthcare professionals and policy makers should consider how demographic characteristics relate to the places people with dementia receive end-of-life care. The care provided to people with dementia in the last year of their life highlights the need for more support to prepare advance care documentation and timely consideration for palliative care. Changes in markers of nutritional status and function in people with advanced dementia may help with identification of terminal phases. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Dementia; End of life; Medical records review; Palliative care; Quality improvement |
| تواريخ الأحداث: | Date Created: 20240109 Date Completed: 20240111 Latest Revision: 20240112 |
| رمز التحديث: | 20240112 |
| مُعرف محوري في PubMed: | PMC10775581 |
| DOI: | 10.1186/s12877-023-04449-1 |
| PMID: | 38195437 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1471-2318 |
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| DOI: | 10.1186/s12877-023-04449-1 |