Citation

Sleeman KE, Perera G, Stewart R, Higginson IJ. Alzheimers Dement. 2018; 14(1): 20-27.

Affiliation

Cicely Saunders Institute, Policy and Rehabilitation, King's College London, London, United Kingdom.

Copyright

(Copyright © 2018, Alzheimer's Association, Publisher Elsevier Publishing)

DOI

10.1016/j.jalz.2017.06.2267

PMID

28838779

Abstract

INTRODUCTION: A fall in hospital deaths in dementia has been interpreted as indicating an improvement in end-of-life care. Whether other indicators of quality of end-of-life care, such as emergency department (ED) attendance, show a similar trend is unclear.

METHODS: Retrospective cohort study using electronic medical records from a large mental health care provider, linked to national mortality and hospital use data (2008-2013).

RESULTS: Of 4867 patients, 78.6% (3824) had at least one ED attendance during their last year of life (mean 2.13, standard deviation 2.34, range 0-54). ED attendance increased over the time period (incidence rate ratio 1.62, 95% confidence interval 1.46-1.80 for 2012-2013 compared with 2008-2009).

DISCUSSION: ED attendance in the last year of life for people with dementia is common and is increasing. Policy makers must pay attention to a broader range of indicators of poor end-of-life care alongside the place of death.

Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Dementia; Emergency department; End-of-life; Palliative; Policy