Discussing end-of-life issues in nursing homes: a nationwide study in France
Number of Authors: 4
2016 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 45, no 3, 395-402 p.Article in journal (Refereed) Published
Background: discussing end-of-life issues with nursing home residents and their relatives is needed to ensure patient-centred care near the end of life. Objectives: this study aimed to estimate the frequency of nursing home physicians discussing end-of-life issues with residents and their relatives and to investigate how discussing end-of-life issues was associated with care outcomes in the last month of life. Methods: post-mortem cohort study in a nationwide, representative sample of 78 nursing home facilities in France. Residents who died from non-sudden causes between 1 October 2013 and 31 May 2014 in these facilities were included n = 674). Results: end-of-life issues were discussed with at most 21.7% of the residents who died during the study period. In one-third of the situations (32.8%), no discussion about end-of-life-related topics ever occurred, either with the resident or with the relatives. Older people with severe dementia were less likely to have discussed more than three of the six end-of-life topics we investigated, compared with residents without dementia (OR = 0.17, 95% CI = 0.08-0.22). In the last month of life, discussing more than three end-of-life issues with the residents or their relatives was significantly associated with reduced odds of dying in a hospital facility (adjusted OR = 0.51, 95% CI = 0.33-0.79) and with a higher likelihood of withdrawing potentially futile life-prolonging treatments (adjusted OR = 2.37, 95% CI = 1.72-3.29). Conclusion: during the last months of life, discussions about end-of-life issues occurred with only a minority of nursing home decedents, although these discussions may improve end-of-life care outcomes.
Place, publisher, year, edition, pages
2016. Vol. 45, no 3, 395-402 p.
end-of-life care, communication, long-term care, nursing home, older people
Geriatrics Gerontology, specializing in Medical and Health Sciences
IdentifiersURN: urn:nbn:se:su:diva-131549DOI: 10.1093/ageing/afw046ISI: 000376097200015PubMedID: 27013503OAI: oai:DiVA.org:su-131549DiVA: diva2:944894