Burdensome Transitions at the End of Life Among Long-Term Care Residents With Dementia

Aaltonen, Mari; Raitanen, Jani; Forma, Leena; Pulkki, Jutta; Rissanen, Pekka; Jylhä, Marja

doi:10.1016/j.jamda.2014.04.018

Cited by 52 publications

(63 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both personal characteristics and system factors were associated with transitions between care settings and hospitalizations toward the end of life, consistent with the Medical Outcome Study framework (Tarlov et al, 1989) and previous research in the end-of-life domain (e.g., Aaltonen et al, 2014; Abarshi et al, 2010; Bähler et al, 2016; Gozalo et al, 2011). The findings were quite similar for transitions and hospitalizations, which is not surprising given that many of the transitions involved hospitalizations; in other words, there is overlap between the variables.…”

Section: Discussionsupporting

confidence: 83%

“…Care transitions can also be stressful for older adults and their families, however (Burge, Lawson, Critchley, & Maxwell, 2005), and are, therefore, sometimes considered indicators of poor quality of care at the end of life (Heyland, Lavery, Tranmer, Shortt, & Taylor, 2000; Wilson et al, 2012). As such, they have received considerable attention in the research literature (e.g., Aaltonen et al, 2014; Gozalo et al, 2011; Teno et al, 2013). …”

mentioning

confidence: 99%

“…Some researchers have counted the number of moves between care settings (e.g., home, nursing home, hospital, and palliative care) toward the end of life (Burge et al, 2005; Lawson, Burge, Critchley, & McIntyre, 2006; Van den Block, Deschepper, Bilsen, Van Casteren, & Deliens, 2007; Van den Block et al, 2015; Wang et al, 2016). Other researchers have defined “burdensome” care transitions to more clearly differentiate between necessary and potentially inappropriate transitions at the end of life (Aaltonen et al, 2014; Aaltonen, Rissanen, Forma, Raitenen, & Jylhä, 2012; Gozalo et al, 2011; Teno et al, 2013). Several types of burdensome care transitions have been identified, including a change in care location in the last 3 days of life or having two or more hospitalizations in the last 90 days of life (Gozalo et al, 2011).…”

mentioning

confidence: 99%

“…For example, in a large database study conducted in the United States involving close to half a million Medicare recipients in nursing homes who had advanced cognitive and functional impairment, 19% experienced at least one burdensome transition in the last 3 months of life (Gozalo et al, 2011). In a similar population-based Finnish study with long-term care residents with dementia, 9% had a burdensome transition in the last 3 months of life, with multiple hospitalizations being the most common transition in this population (Aaltonen et al, 2014). In Belgium, the Netherlands, Italy, and Spain, from 55% to 60% of patients registered with general practitioners had one care transition in the last 3 months before death and between 5% and 12% patients had three or more care transitions (Van den Block et al, 2015).…”

mentioning

confidence: 99%

“…Research further indicates that transitions between care settings are influenced by a variety of personal factors, such as age, sex (e.g., Aaltonen et al, 2014; Abarshi et al, 2010; Bähler, Signorell, & Reich, 2016; Gozalo et al, 2011; Lawson et al, 2006; Wang et al, 2016) and medical conditions, such as dementia (Aaltonen et al, 2012). Regional variation in care transitions has also been shown (Aaltonen, Forma, Rissanen, Raitenen, & Jylhä, 2013; Gozalo et al, 2011; Wang et al, 2016), suggesting that transitions are influenced by regionally determined health care practices or health care supply.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Transitions Between Care Settings at the End of Life Among Older Homecare Recipients

Abraham

Menec

2016

Gerontology and Geriatric Medicine

View full text Add to dashboard Cite

Objectives: Objectives were to (a) describe transitions between care settings in older homecare recipients at the end of life, and (b) examine what personal (e.g., age, sex) and health system factors (e.g., hospital bed supply) predict care transitions. Methods: The study involved analysis of administrative health care data and was based on a complete cohort of homecare recipients aged 65 years or older who died in Manitoba, Canada between 2003 and 2006 (N = 7,866). Results: More than half of homecare recipients had at least one care transition in the last 30 days before death and 21% had two or more hospitalizations in the last 90 days. Both personal characteristics and health system factors were related to transitions and hospitalizations. Discussion: The findings suggest that homecare recipients are an important population to focus on in terms of reducing potentially burdensome transitions and enhancing the end-of-life experience for them and their family.

show abstract

Section: Discussionsupporting

confidence: 83%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Transitions Between Care Settings at the End of Life Among Older Homecare Recipients

Abraham

Menec

2016

Gerontology and Geriatric Medicine

View full text Add to dashboard Cite

show abstract

A systematic review of specialty dementia care units in long‐term care settings

Orth

Flowers

Betz

et al. 2023

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Background Alzheimer's disease and related dementias (ADRD) are common among nursing home residents. Yet, conclusive evidence regarding best care practices among this population is lacking. Objectives of this systematic review were to explore features of dementia specialty care units (DSCUs) in long‐term care settings and examine benefits for residents, staff, families, and facilities. Methods PubMed, CINAHL, and PsychINFO were searched to identify articles involving DSCUs in long‐term care settings published in English with full text available between 01.01.2008 and 06.03.2022. Articles containing empirical data about ADRD special care in long‐term care settings were included in the review. Articles focused on clinic‐based or out‐patient dementia care programs (e.g., adult day care) were excluded. Articles were categorized based on geography (U.S. vs. international) and study design: interventions, descriptive studies, or comparison studies (traditional vs. specialty ADRD care). Results Our review included 38 U.S. articles and 54 articles from 15 international countries. In the U.S., 12 intervention, 13 descriptive, and 13 comparison studies met the inclusion criteria. Articles from international countries included 22 intervention, 20 descriptive, and 12 comparison studies. Results were mixed in terms of the efficacy of DSCUs. Promising DSCU features include small‐scale settings, dementia‐educated staff, and multidisciplinary approaches to care. Conclusion Overall, our review did not find conclusive evidence regarding the benefits of DSCUs in long‐term care settings. No rigorous study designs were found examining ‘special’ features of DSCUs and associations with outcomes among residents, family, staff, and the facility. Randomized clinical trials are needed to disentangle the ‘special’ features of DSCUs.

show abstract

Krankenhausaufenthalte von Pflegeheimbewohnenden am Lebensende: Eine empirische Bestandsaufnahme

et al. 2022

View full text Add to dashboard Cite

ZusammenfassungPflegeheime sind Orte des letzten Lebensabschnitts und des Sterbens. Ein Drittel der innerhalb eines Jahres verstorbenen AOK-Versicherten lebte in einem Pflegeheim. Obwohl sich die gesetzlichen Rahmenbedingungen für palliative Versorgungsansätze in den letzten 15 Jahren erheblich verändert haben, birgt die Versorgung Sterbender vielfältige Herausforderungen für das Setting Pflegeheim. Vor diesem Hintergrund beleuchtet der Beitrag Krankenhaus-Verlegungen von Pflegeheimbewohnenden unmittelbar vor dem Lebensende auf Basis von AOK-Routinedaten. Sichtbar wird, dass sich die Krankenhausaufenthalte vor dem Versterben verdichten und zudem auch potenziell vermeidbare Behandlungsanlässe als Ursache dokumentiert sind. Der vorgelegte Beitrag versteht sich in diesem Sinne als empirische Bestandsaufnahme. Er soll Anstoß sein für eine Diskussion der Frage, ob und wenn ja welcher Veränderung es bedarf, um eine rechtzeitige und konsequente Erfassung der Versorgungswünsche von Bewohnenden mit Blick auf ihr Lebensende zu sichern.

show abstract

Burdensome Transitions at the End of Life Among Long-Term Care Residents With Dementia

Cited by 52 publications

References 23 publications

Transitions Between Care Settings at the End of Life Among Older Homecare Recipients

Transitions Between Care Settings at the End of Life Among Older Homecare Recipients

A systematic review of specialty dementia care units in long‐term care settings

Krankenhausaufenthalte von Pflegeheimbewohnenden am Lebensende: Eine empirische Bestandsaufnahme

Contact Info

Product

Resources

About