The last 3 days of life in three different care settings in The Netherlands

Veerbeek, Laetitia; Zuylen, Lia van; Swart, Siebe; Maas, P.J. van der; Heide, Agnes van der

doi:10.1007/s00520-006-0211-x

Cited by 28 publications

(30 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, the scant literature on symptoms in the last days of life focused primarily on the last 48 hours (9, 25, 26) and in other care settings (e.g., hospices, nursing homes) (8, 27, 28). We found that the frequency of many symptoms was high and increased over time.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Symptom Expression in the Last Seven Days of Life Among Cancer Patients Admitted to Acute Palliative Care Units

Hui

Santos

Chisholm

et al. 2015

Journal of Pain and Symptom Management

118

View full text Add to dashboard Cite

Context The symptom burden in the last week of life of patients with advanced cancer has not been well characterized. Objectives To examine the frequency, intensity, and predictors for symptoms in the last seven days of life among patients who were able to communicate and died in an acute palliative care unit (APCU). Methods We systematically documented the Edmonton Symptom Assessment System (ESAS) daily and 15 symptoms twice daily on consecutive advanced cancer patients admitted to APCUs at M.D. Anderson Cancer Center (USA) and Barretos Cancer Hospital (Brazil) from admission to death or discharge in 2010/2011. We examined the frequency and intensity of the symptoms from death backwards. Results A total of 203 of 357 patients died. The proportion of patients able to communicate decreased from 80% to 39% over the last seven days of life. ESAS anorexia (P=0.001 in longitudinal analyses), drowsiness (P<0.0001), fatigue (P<0.0001), poor well-being (P=0.01) and dyspnea (P<0.0001) increased in intensity closer to death. In contrast, ESAS depression (P=0.008) decreased over time. Dysphagia to solids (P=0.01) and liquids (P=0.005), and urinary incontinence (P=0.0002) also were present in an increasing proportion of patients in the last few days of life. In multivariate analyses, female sex, non-Hispanic race and lung cancer were significantly associated with higher ESAS symptom expression (odds ratio>1). Conclusion Despite intensive management in APCUs, some cancer patients continue to experience high symptom burden as they approached death.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Finally, findings from this study are only applicable to cancer patients admitted to APCUs. Because symptom expression may differ by disease and setting (28), further studies are needed to characterize the symptom burden in other populations in the last days of life.…”

Section: Discussionmentioning

confidence: 99%

Symptom Expression in the Last Seven Days of Life Among Cancer Patients Admitted to Acute Palliative Care Units

Hui

Santos

Chisholm

et al. 2015

Journal of Pain and Symptom Management

118

View full text Add to dashboard Cite

show abstract

“…Seven more recent studies showed inconsistencies in what was considered a 'home death', in the measurement of pain and in the groups compared. 50,[54][55][56][57][58][59][60] This highlights the need for greater clarity and consistency in measurement and patient selection.…”

Section: Is Home Care or Home Death Better Than Other Places -For Examentioning

confidence: 99%

Dying at home – is it better: A narrative appraisal of the state of the science

et al. 2013

View full text Add to dashboard Cite

Background: Achieving home care and home death is increasingly used as an outcome measure of palliative care services. Aim: To appraise the state of the science on dying at home. Methods: Appraisal and narrative review developed from a plenary presentation at the European Association for Palliative Care (EAPC) 2012 meeting examining the research on variations and trends in place of death, factors associated with dying in the preferred place, presenting evidence on outcomes for those dying at home and suggesting future research questions. Results: Meeting patients' preferences and creating home-like environments has been a major concern for hospice and palliative care since its inception. During the 20 th century, in many countries, hospital deaths increased and home deaths reduced. Despite the fact that this trend has been halted or reversed in some countries (notably the United States, Canada and, more recently, the United Kingdom) in the last 5-20 years, a home death is still a distant reality for the majority, even though evidence shows it is the most commonly preferred place to die. Epidemiological studies identified factors associated with home death, including affluence, patients' preferences, provision of home care and extended family support. Evidence about the benefits of home care is conflicting, but recent data suggest that holistic well-being may be greater at home. Implications: We call for further analyses of variations in place of care and place of death and robust studies on how patients and families formulate and change preferences over time. Regular monitoring of outcomes, quality and costs of palliative home care is urged.

show abstract

“…8,15 Also, previous literature suggests certain characteristics may influence recognition of patients' death in the near future. 16,17 However, related studies have been limited to specific settings, 16,18,19 diagnoses, 16,20,21 age groups, 17,21 and functional states. 17,22 To the best of this study's knowledge, this is the first nationwide study that examines the timing of and the factors associated with recognising death in the near future from a general patient population.…”

Section: Introductionmentioning

confidence: 99%