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Comfort and clinical events at the end of life of nursing home residents with and without dementia: The six-country epidemiological PACE study

Research output: Contribution to journalJournal article

E-pub ahead of print
  • R. Miranda
  • J.T. van der Steen
  • T. Smets
  • N. Van den Noortgate
  • L. Deliens
  • S. Payne
  • M. Kylänen
  • K. Szczerbińska
  • G. Gambassi
  • L. Van den Block
  • on behalf of PACE
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<mark>Journal publication date</mark>10/03/2020
<mark>Journal</mark>International Journal of Geriatric Psychiatry
Number of pages9
Publication statusE-pub ahead of print
Early online date10/03/20
Original languageEnglish

Abstract

Objectives: We aimed to investigate the occurrence rates of clinical events and their associations with comfort in dying nursing home residents with and without dementia. Methods: Epidemiological after-death survey was performed in nationwide representative samples of 322 nursing homes in Belgium, Finland, Italy, the Netherlands, Poland, and England. Nursing staff reported clinical events and assessed comfort. The nursing staff or physician assessed the presence of dementia; severity was determined using two highly discriminatory staff-reported instruments. Results: The sample comprised 401 residents with advanced dementia, 377 with other stages of dementia, and 419 without dementia (N = 1197). Across the three groups, pneumonia occurred in 24 to 27% of residents. Febrile episodes (unrelated to pneumonia) occurred in 39% of residents with advanced dementia, 34% in residents with other stages of dementia and 28% in residents without dementia (P =.03). Intake problems occurred in 74% of residents with advanced dementia, 55% in residents with other stages of dementia, and 48% in residents without dementia (P