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Hospitalizations of nursing home residents with dementia in the last month of life: Results from a nationwide survey

(2014) PALLIATIVE MEDICINE. 28(9). p.1110-1117
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Organization
Abstract
Background: Hospitalizations of nursing home residents with dementia may not be uncommon. However, evidence from epidemiological studies outside the United States and knowledge about the circumstances of hospitalizations are lacking. Aim: To examine the proportion of nursing home residents with dementia hospitalized in the last month of life and factors associated with hospitalization. Design: The design is stratified cluster sampling survey. Nurses retrospectively registered demographic and dementia-related information about deceased residents with dementia. This included information about hospitalizations, persons involved in hospitalization decisions and type and content of information transferred when hospitalized. Setting/participants: Nursing home residents dying with dementia in Belgium (Flanders) in 2010. Results: In the final month of life, 19.5% of nursing home residents dying with dementia (N = 198) were hospitalized, including 4.6% admitted to an intensive care unit. For 12.2% of residents dying with dementia, a do-not-hospitalize advance directive was present, for 57.0%, a do-not-hospitalize general physician-order. Residents without a do-not-hospitalize general physician-order were more likely of being hospitalized (adjusted odds ratio: 3.4; 95% confidence interval: 1.3-8.7). None of the hospitalizations occurred at the request of the resident; 37% were at the request of relatives; curative or life-prolonging treatments were the most frequent reasons given. Information about the resident's nursing care or medical treatment was transferred in almost all hospitalizations, information about wishes and preferences for future care in 19%. Conclusion: Hospitalization in Belgian nursing home residents with dementia in the last month of life was common. Documentation of do-not-hospitalize physician-orders in the resident's medical files may prevent hospitalizations.
Keywords
CARE, DEATH, PREVALENCE, BELGIUM, FLANDERS, QUALITY, PLACE, OLDER PERSONS, ADVANCE DIRECTIVES, OF-THE-LITERATURE, hospitalization, nursing homes, Dementia

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Citation

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MLA
Houttekier, Dirk, An Vandervoort, Lieve Van den Block, et al. “Hospitalizations of Nursing Home Residents with Dementia in the Last Month of Life: Results from a Nationwide Survey.” PALLIATIVE MEDICINE 28.9 (2014): 1110–1117. Print.
APA
Houttekier, D., Vandervoort, A., Van den Block, L., van der Steen, J. T., Vander Stichele, R., & Deliens, L. (2014). Hospitalizations of nursing home residents with dementia in the last month of life: Results from a nationwide survey. PALLIATIVE MEDICINE, 28(9), 1110–1117.
Chicago author-date
Houttekier, Dirk, An Vandervoort, Lieve Van den Block, Jenny T van der Steen, Robert Vander Stichele, and Luc Deliens. 2014. “Hospitalizations of Nursing Home Residents with Dementia in the Last Month of Life: Results from a Nationwide Survey.” Palliative Medicine 28 (9): 1110–1117.
Chicago author-date (all authors)
Houttekier, Dirk, An Vandervoort, Lieve Van den Block, Jenny T van der Steen, Robert Vander Stichele, and Luc Deliens. 2014. “Hospitalizations of Nursing Home Residents with Dementia in the Last Month of Life: Results from a Nationwide Survey.” Palliative Medicine 28 (9): 1110–1117.
Vancouver
1.
Houttekier D, Vandervoort A, Van den Block L, van der Steen JT, Vander Stichele R, Deliens L. Hospitalizations of nursing home residents with dementia in the last month of life: Results from a nationwide survey. PALLIATIVE MEDICINE. 2014;28(9):1110–7.
IEEE
[1]
D. Houttekier, A. Vandervoort, L. Van den Block, J. T. van der Steen, R. Vander Stichele, and L. Deliens, “Hospitalizations of nursing home residents with dementia in the last month of life: Results from a nationwide survey,” PALLIATIVE MEDICINE, vol. 28, no. 9, pp. 1110–1117, 2014.
@article{5771585,
  abstract     = {{Background: Hospitalizations of nursing home residents with dementia may not be uncommon. However, evidence from epidemiological studies outside the United States and knowledge about the circumstances of hospitalizations are lacking. 
Aim: To examine the proportion of nursing home residents with dementia hospitalized in the last month of life and factors associated with hospitalization. 
Design: The design is stratified cluster sampling survey. Nurses retrospectively registered demographic and dementia-related information about deceased residents with dementia. This included information about hospitalizations, persons involved in hospitalization decisions and type and content of information transferred when hospitalized. 
Setting/participants: Nursing home residents dying with dementia in Belgium (Flanders) in 2010. 
Results: In the final month of life, 19.5% of nursing home residents dying with dementia (N = 198) were hospitalized, including 4.6% admitted to an intensive care unit. For 12.2% of residents dying with dementia, a do-not-hospitalize advance directive was present, for 57.0%, a do-not-hospitalize general physician-order. Residents without a do-not-hospitalize general physician-order were more likely of being hospitalized (adjusted odds ratio: 3.4; 95% confidence interval: 1.3-8.7). None of the hospitalizations occurred at the request of the resident; 37% were at the request of relatives; curative or life-prolonging treatments were the most frequent reasons given. Information about the resident's nursing care or medical treatment was transferred in almost all hospitalizations, information about wishes and preferences for future care in 19%. 
Conclusion: Hospitalization in Belgian nursing home residents with dementia in the last month of life was common. Documentation of do-not-hospitalize physician-orders in the resident's medical files may prevent hospitalizations.}},
  author       = {{Houttekier, Dirk and Vandervoort, An and Van den Block, Lieve and van der Steen, Jenny T and Vander Stichele, Robert and Deliens, Luc}},
  issn         = {{0269-2163}},
  journal      = {{PALLIATIVE MEDICINE}},
  keywords     = {{CARE,DEATH,PREVALENCE,BELGIUM,FLANDERS,QUALITY,PLACE,OLDER PERSONS,ADVANCE DIRECTIVES,OF-THE-LITERATURE,hospitalization,nursing homes,Dementia}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1110--1117}},
  title        = {{Hospitalizations of nursing home residents with dementia in the last month of life: Results from a nationwide survey}},
  url          = {{http://dx.doi.org/10.1177/0269216314535962}},
  volume       = {{28}},
  year         = {{2014}},
}

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