Hospitalizations of Nursing Home Residents with Dementia in the Last Month of Life: Results from a Nationwide Study

Dirk Houttekier, An Vandervoort, Lieve Van den Block, J. Van Der Steen, Robert Vander Stichele, Luc Deliens

Research output: Contribution to journalMeeting abstract (Journal)

Abstract

Introduction: Nursing home residents with dementia at the end of life may find hospitalizations burdensome; evidence from epidemiological studies in Europe is sparse, as is knowledge about who is involved in hospitalization decisions and whether or not information was transferred with the resident. Methods: We used a survey with cluster-randomized sampling among Belgian nursing homes in 2010. Nurses from the sampled nursing homes registered retrospectively information about care in the last three months of life of residents who died with dementia. Results: In the final month of life 19.5% of nursing home residents with dementia (N=198) were hospitalized, including 4.6% admitted to an intensive care unit. For 11.1% of all residents a do-not-hospitalize advance directive was present, for 54.0% a do-not hospitalize GP-order. None of the hospitalizations occurred at the request of the resident; 37% were at the request of relatives; curative or life prolonging treatments were the most frequent reasons given. In-house palliative care consultants were involved in none of the hospitalization decisions. Information about the resident's nursing care or medical treatment was transferred in almost all hospitalizations, information about wishes and preferences for future care in 19%. Residents without a donot- hospitalize GP-order were more likely of being hospitalized (AOR: 4.9; 95%CI: 2.1-11.1). Eventually, 8.5% of hospitalized residents died outside the nursing home. Discussion: The hospitalization rate in the last month of life in Belgian nursing home residents with dementia was significant. Timely and open communication with residents and relatives about future hospitalizations and documentation of do-not-hospitalize advance directives or GP-orders in the resident's medical files may prevent avoidable hospitalizations.
Original languageEnglish
Pages (from-to)56-56
Number of pages1
JournalEuropean Journal of Palliative Care
Publication statusPublished - 2013
EventUnknown -
Duration: 1 Jan 2013 → …

Keywords

  • Nursing homes
  • Dementia
  • Hospitalization

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