Since the population is ageing, more and more people die at old and very old age, often after a long period of chronic illness. Because persistent therapy at the end of life of elderly petients is questioned, medical end-of-life decisions occur frequently in this population. The present doctoral thesis focuses on en-of-life care for elderly patients and attemps to contribute to the improvement of the quality of end-of-life care for these patients.
Of all deaths of people aged 65 years or older in Flanders, half occurs in hospitals and one quarter in nursing homes (including homes for the elderly and care homes). Since the number of deaths in these settings represent a major proportion of all deaths, the most relevant medical end-of-life decisions in hospitals and nursing homes will be investigated. On acute geratric wards the availibility of a do-not-resuscitate policy will be investigated, as well as the decision-making itself. In the more 'care-based nursing homes it will be investigated to what extent the conditions for advance care planning are fullfilled, how often advance care planning is used for patients and how often medical end-of-life decisions are made.