Institute of Public Health, University of Cambridge, Cambridge.
Br J Gen Pract. 2010 Apr;60(573):171-9. doi: 10.3399/bjgp10X483959.
Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce.
To examine the place of residence or care of > or =85 year-olds less than a year before death, and their place of death, and to map individual changes between the two.
Population-based cohort study.
Cambridge City over-75s Cohort (CC75C) study, UK.
Retrospective analysis of prospective data from males and females aged > or =85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage.
Only 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes.
More than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old.
最年长的老年人的死亡率增长最快，但关于他们在生命末期的护理场所转移的数据却很少。
研究 85 岁以上人群在死亡前不到一年的居住地或护理地，以及他们的死亡地，并绘制两者之间的个体变化图。
基于人群的队列研究。
英国剑桥市 75 岁以上人群队列（CC75C）研究。
对死亡时年龄大于或等于 85 岁且在参与任何 CC75C 调查的一年内死亡的男性和女性的前瞻性数据进行回顾性分析（n=320）；死亡证明链接。
只有 7%的人在生命的最后一年改变了地址，但 52%的人在死亡时不在他们通常的地址。在接受访谈前不到一年时，超过三分之二的人居住在社区，但只有不到三分之一的人在家中去世（不到五分之一住在庇护性住房中）。养老院是大多数在那里去世的人的常居地（77%在养老院，87%在护理院），但 15%的急性医院死亡来自养老院。
在这项研究中，超过一半的高龄个体样本在生命的最后一年中经历了居住地或护理地的变化。这些发现进一步支持了在所有环境中改善临终关怀的呼吁，无论年龄大小，以避免不必要的转移。研究数据提供了一个基线，可以帮助规划和监测在生命末期促进老年人选择护理地点的举措。
