Who Dies at Home? Determinants of Site of Death for Community‐Based Long‐Term Care Patients

Fried, Terri R.; Pollack, Daphna; Drickamer, Margaret A.; Tinetti, Mary E.

doi:10.1111/j.1532-5415.1999.tb01897.x

Cited by 58 publications

(41 citation statements)

References 14 publications

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“…Similar to Fried et al, 8 women are more likely to die at home. Univariate analyses indicate that health conditions associated with home death include poor functional status, cognitive impairment, weight loss, daily incontinence, and delirium.…”

Section: Discussionsupporting

confidence: 65%

“…Functional and cognitive impairment also have been associated with home death in earlier studies. 7,8 To the researcher's knowledge, this study was the first to identify a relationship between weight loss, daily incontinence, and delirium to home death. A relationship among these variables is assumed to be likely because they are symptoms typically found among patients with advanced terminal illness.…”

Section: Discussionmentioning

confidence: 97%

“…Keywords: home health care; place of death; death at home; terminal care; informal caregiver; interRAI palliative care cohabitate with a caregiver(s), 7,10 live with their child(ren), 8 have available family supports in place, 7,11 and have more than 1 caregiver 6 are more likely to die at home. Home death is also dependent on the health of the caregiver(s), 10 so patients who have family or friends and who are in fair to poor health are less likely to die at home.…”

mentioning

confidence: 99%

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Determinants of Home Death in Palliative Home Care: Using the interRAI Palliative Care to Assess End-of-Life Care

Brink

Smith

2008

Am J Hosp Palliat Care

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Many terminally ill patients are given the choice to die at home. This study identified determinants of home death among patients receiving palliative home care. Health information was collected using the interRAI palliative care assessment tool. The sample included health information from 536 patients receiving home health care from one community care access centre in Ontario, Canada. Patients who died at home were more likely to be functionally impaired and less likely to live alone. The patients' wish to die at home and the family's ability to cope were strong determinants of home death. This study suggests that the presence of a supportive family that is able to work with the health care team to implement a plan of care is important to the patients' ability to die at home. This study highlights the need to treat the patient and the caregiver(s) as a unit of care.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

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Determinants of Home Death in Palliative Home Care: Using the interRAI Palliative Care to Assess End-of-Life Care

Brink

Smith

2008

Am J Hosp Palliat Care

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“…22 Care home residence in CC75C has risen more sharply than national trends in longterm-care availability, 23 and the proportions of residential care and nursing home deaths are both higher and increasing more than national rates. There is growing evidence that, just as home deaths are 24,25 levels of deaths in institutions are strongly influenced by access, [26][27][28][29] a finding from younger old-age groups that the present study suggests is similar for the oldest old. Conversely, the present study findings show proportions dying in hospital that are 5-10% lower than nationally for both age-bands.…”

Section: Comparison With Existing Literaturesupporting

confidence: 70%

Place of death for the ‘oldest old’: ≥85-year-olds in the CC75C population-based cohort

Fleming

Zhao²,

Farquhar³

et al. 2010

Br J Gen Pract

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Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce. AimTo examine the place of residence or care of ≥85 yearolds less than a year before death, and their place of death, and to map individual changes between the two. Design of studyPopulation-based cohort study. SettingCambridge City over-75s Cohort (CC75C) study, UK. MethodRetrospective analysis of prospective data from males and females aged ≥85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage. ResultsOnly 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes. ConclusionMore than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old. Keywords aged; aged 80 or over; aging in place; frail elderly; terminal care. INTRODUCTIONEnd-of-life care for older people is now an acknowledged priority.1 Recent UK policy initiatives and reports recognise the increasing number of people who will be dying in very old age.2-5 Emphasis on a care pathway approach highlights the importance of the place of care, place of death, and transitions between them.6-8 The NHS End of Life Care Programme's aims include reducing emergency admissions and transfers from care homes to hospital in the last week of life, alongside providing the support needed to enable people to die where they choose. 9 The policy drive to facilitate 'good deaths' at home envisages savings on costly acute care, enhancing value for money at the same time as choice, quality, and equality. 2,10,11 In many developed countries, deaths, including inhospital deaths, are rising fastest among ≥85-year olds. 1,12,13 Data are scarce on older people's place of care trajectories before death,

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“…Fried et al [3] found that, in people 65 yrs of age, a state of functional or cognitive dependence, or the presence of certain illnesses, was often associated with a greater risk of dying at home than in a hospital. On the other hand, Zanobetti et al [4] reported a correlation between PM10 exposure and hospitalization for respiratory disorders with an accentuated risk in patients with cardiovascular disease.…”

Section: Daily Respiratory Mortality and Pm10 Pollution In Mexico Citymentioning

confidence: 99%

Daily respiratory mortality and PM₁₀pollution in Mexico city

Filleul¹,

Vandentorren²,

Baldi³

et al. 2001

Eur Respir J

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Who Dies at Home? Determinants of Site of Death for Community‐Based Long‐Term Care Patients

Cited by 58 publications

References 14 publications

Determinants of Home Death in Palliative Home Care: Using the interRAI Palliative Care to Assess End-of-Life Care

Determinants of Home Death in Palliative Home Care: Using the interRAI Palliative Care to Assess End-of-Life Care

Place of death for the ‘oldest old’: ≥85-year-olds in the CC75C population-based cohort

Daily respiratory mortality and PM₁₀pollution in Mexico city

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Who Dies at Home? Determinants of Site of Death for Community‐Based Long‐Term Care Patients

Cited by 58 publications

References 14 publications

Determinants of Home Death in Palliative Home Care: Using the interRAI Palliative Care to Assess End-of-Life Care

Determinants of Home Death in Palliative Home Care: Using the interRAI Palliative Care to Assess End-of-Life Care

Place of death for the ‘oldest old’: ≥85-year-olds in the CC75C population-based cohort

Daily respiratory mortality and PM10pollution in Mexico city

Contact Info

Product

Resources

About

Daily respiratory mortality and PM₁₀pollution in Mexico city