Final published version
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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Dying in long-term care facilities in Europe
T2 - The PACE epidemiological study of deceased residents in six countries
AU - Honinx, Elisabeth
AU - Van Dop, Nanja
AU - Smets, Tinne
AU - Deliens, Luc
AU - Van Den Noortgate, Nele
AU - Froggatt, Katherine
AU - Gambassi, Giovanni
AU - Kylänen, Marika
AU - Onwuteaka-Philipsen, Bregje
AU - Szczerbińska, Katarzyna
AU - Van Den Block, Lieve
AU - Gatsolaeva, Yuliana
AU - Miranda, Rose
AU - Pivodic, Lara
AU - Tanghe, Marc
AU - Van Hout, Hein
AU - Pasman, Roeline H.R.W.
AU - Oosterveld-Vlug, Mariska
AU - Piers, Ruth
AU - Wichmann, Anne B.
AU - Engels, Yvonne
AU - Vernooij-Dassen, Myrra
AU - Hockley, Jo
AU - Payne, Sheila
AU - Leppäaho, Suvi
AU - Barańska, Ilona
AU - Pautex, Sophie
AU - Bassal, Catherine
AU - Mammarella, Federica
AU - Mercuri, Martina
AU - Rossi, Paola
AU - Segat, Ivan
AU - Stodolska, Agata
AU - Adang, Eddy
AU - Andreasen, Paula
AU - Kuitunen-Kaija, Outi
AU - Moore, Danni Collingridge
AU - Pac, Agnieszka
AU - Kijowska, Violetta
AU - Ten Koppel, Maud
AU - Van Der Steen, Jenny T.
AU - De Paula, Emilie Morgan
PY - 2019/8/30
Y1 - 2019/8/30
N2 - Background: By 2030, 30% of the European population will be aged 60 or over and those aged 80 and above will be the fastest growing cohort. An increasing number of people will die at an advanced age with multiple chronic diseases. In Europe at present, between 12 and 38% of the oldest people die in a long-term care facility. The lack of nationally representative empirical data, either demographic or clinical, about people who die in long-term care facilities makes appropriate policy responses more difficult. Additionally, there is a lack of comparable cross-country data; the opportunity to compare and contrast data internationally would allow for a better understanding of both common issues and country-specific challenges and could help generate hypotheses about different options regarding policy, health care organization and provision. The objectives of this study are to describe the demographic, facility stay and clinical characteristics of residents dying in long-term care facilities and the differences between countries. Methods: Epidemiological study (2015) in a proportionally stratified random sample of 322 facilities in Belgium, Finland, Italy, the Netherlands, Poland and England. The final sample included 1384 deceased residents. The sampled facilities received a letter introducing the project and asking for voluntary participation. Facility manager, nursing staff member and treating physician completed structured questionnaires for all deaths in the preceding 3 months. Results: Of 1384 residents the average age at death ranged from 81 (Poland) to 87 (Belgium, England) (p < 0.001) and length of stay from 6 months (Poland, Italy) to 2 years (Belgium) (p < 0.05); 47% (the Netherlands) to 74% (Italy) had more than two morbidities and 60% (England) to 83% (Finland) dementia, with a significant difference between countries (p < 0.001). Italy and Poland had the highest percentages with poor functional and cognitive status 1 month before death (BANS-S score of 21.8 and 21.9 respectively). Clinical complications occurred often during the final month (51.9% England, 66.4% Finland and Poland). Conclusions: The population dying in long-term care facilities is complex, displaying multiple diseases with cognitive and functional impairment and high levels of dementia. We recommend future policy should include integration of high-quality palliative and dementia care.
AB - Background: By 2030, 30% of the European population will be aged 60 or over and those aged 80 and above will be the fastest growing cohort. An increasing number of people will die at an advanced age with multiple chronic diseases. In Europe at present, between 12 and 38% of the oldest people die in a long-term care facility. The lack of nationally representative empirical data, either demographic or clinical, about people who die in long-term care facilities makes appropriate policy responses more difficult. Additionally, there is a lack of comparable cross-country data; the opportunity to compare and contrast data internationally would allow for a better understanding of both common issues and country-specific challenges and could help generate hypotheses about different options regarding policy, health care organization and provision. The objectives of this study are to describe the demographic, facility stay and clinical characteristics of residents dying in long-term care facilities and the differences between countries. Methods: Epidemiological study (2015) in a proportionally stratified random sample of 322 facilities in Belgium, Finland, Italy, the Netherlands, Poland and England. The final sample included 1384 deceased residents. The sampled facilities received a letter introducing the project and asking for voluntary participation. Facility manager, nursing staff member and treating physician completed structured questionnaires for all deaths in the preceding 3 months. Results: Of 1384 residents the average age at death ranged from 81 (Poland) to 87 (Belgium, England) (p < 0.001) and length of stay from 6 months (Poland, Italy) to 2 years (Belgium) (p < 0.05); 47% (the Netherlands) to 74% (Italy) had more than two morbidities and 60% (England) to 83% (Finland) dementia, with a significant difference between countries (p < 0.001). Italy and Poland had the highest percentages with poor functional and cognitive status 1 month before death (BANS-S score of 21.8 and 21.9 respectively). Clinical complications occurred often during the final month (51.9% England, 66.4% Finland and Poland). Conclusions: The population dying in long-term care facilities is complex, displaying multiple diseases with cognitive and functional impairment and high levels of dementia. We recommend future policy should include integration of high-quality palliative and dementia care.
KW - End-of-life care
KW - Long-term care facility
KW - Nursing homes
KW - Palliative care
KW - Policy
U2 - 10.1186/s12889-019-7532-4
DO - 10.1186/s12889-019-7532-4
M3 - Journal article
C2 - 31470875
AN - SCOPUS:85071751647
VL - 19
JO - BMC Public Health
JF - BMC Public Health
SN - 1471-2458
IS - 1
M1 - 1199
ER -