Terminal Care for Persons with Advanced Dementia in the Nursing Home and Home Care Settings
dc.contributor.author | Mitchell, Susan L. | en_US |
dc.contributor.author | Morris, John N. | en_US |
dc.contributor.author | Park, Pil S. | en_US |
dc.contributor.author | Fries, Brant E. | en_US |
dc.date.accessioned | 2009-07-10T19:12:16Z | |
dc.date.available | 2009-07-10T19:12:16Z | |
dc.date.issued | 2004-12-01 | en_US |
dc.identifier.citation | Mitchell, Susan L.; Morris, John N.; Park, Pil S.; Fries, Brant E. (2004). "Terminal Care for Persons with Advanced Dementia in the Nursing Home and Home Care Settings." Journal of Palliative Medicine 7(6): 808-816 <http://hdl.handle.net/2027.42/63373> | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/63373 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15684848&dopt=citation | en_US |
dc.description.abstract | Background: Many older persons with advanced dementia receive terminal care in nursing homes, others remain in the community with home care services. Objectives: To describe and compare the end-of-life experience of persons dying with advanced dementia in the nursing home and home care settings. Design: Retrospective cohort study. Setting/Subjects: Persons 65 years or older with advanced dementia who died within 1 year of admission to either a nursing home in Michigan between July 1, 1998 until December 31, 2000 (n = 2730), or the state's publicly funded home and community-based services from October 1, 1998 until December 31, 2001 (n = 290). Measurements: Data were derived from the Minimum Data Set (MDS)-Nursing home Version 2.0 for the institutionalized sample, and the MDS-Home Care for the community-based sample. Variables from the MDS assessment completed within 180 days of death were used to describe the end-of-life experiences of these two groups. Results: Nursing home residents dying with advanced dementia were older, had greater functional impairment, and more behavior problems compared to home care clients. Few subjects in the nursing home (10.3%) and home care (15.6%) cohorts were perceived to have less than 6 months to live. Only 5.7% of nursing home residents and 10.7% home care clients were referred to hospice. Hospitalizations were frequent: nursing home, 43.7%; home care, 31.5%. Pain and shortness of breath were common in both settings. End-of-life variables independently associated with nursing home versus home care included: hospice (adjusted odds ratio [AOR] 0.26, 95% confidence interval [CI], 0.16–0.43), life expectancy less than 6 months (AOR 0.31; 95% CI, 0.20–0.48), advance directives (AOR, 1.48; 95% CI, 1.11–1.96), pain (AOR, 0.38; 95% CI, 0.29–0.50), shortness of breath (AOR 0.20; 95% CI (0.13-0.28), and oxygen therapy (AOR, 2.47; 95% CI, 1.51–4.05). Conclusions: Persons dying with advanced dementia admitted to nursing homes have different characteristics compared to those admitted to home care services. Their end-of-life experiences also differ in these two sites of care. However, palliative care was not optimal in either setting. | en_US |
dc.format.extent | 143138 bytes | |
dc.format.extent | 2489 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Mary Ann Liebert, Inc., publishers | en_US |
dc.title | Terminal Care for Persons with Advanced Dementia in the Nursing Home and Home Care Settings | en_US |
dc.type | Article | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.identifier.pmid | 15684848 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/63373/1/jpm.2004.7.808.pdf | |
dc.identifier.doi | doi:10.1089/jpm.2004.7.808 | en_US |
dc.identifier.source | Journal of Palliative Medicine | en_US |
dc.identifier.source | Journal of Palliative Medicine | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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