Tan Heather, Digby Robin, Bloomer Melissa, Wang Yixin, O'Connor Margaret
Palliative Care Research Team, Monash University, Melbourne, Victoria, Australia.
Australas J Ageing. 2013 Sep;32(3):184-7. doi: 10.1111/j.1741-6612.2012.00654.x. Epub 2013 Jan 31.
To investigate processes at the end of life for patients who died in a subacute evaluation and management facility for older people.
A retrospective chart audit for patients (n = 55) who died in the previous 2 years was undertaken, recording a number of significant variables.
Despite diagnosis of comorbid medical conditions, most participants were admitted for improved functioning or assessment for alternative accommodation. Consistent with this focus, the key contact person was most often an allied health team member. Not For Resuscitation order and/or power of attorney documents on admission were uncommon (<30%) as were referrals to palliative care specialist staff (13%), although an end-of-life discussion was recorded (90%) and often included as a new goal of care (71%).
Factors likely to improve end-of-life care include advance care planning, earlier recognition of short prognosis and staff education.
调查在一家老年亚急性评估与管理机构中死亡患者的临终过程。
对过去两年内死亡的患者（n = 55）进行回顾性病历审核，记录若干重要变量。
尽管诊断出患有合并症，但大多数参与者入院是为了改善功能或进行替代住所评估。与此重点一致，关键联系人通常是一名联合健康团队成员。入院时的“不进行心肺复苏”医嘱和/或授权委托书文件并不常见（<30%），转介至姑息治疗专科工作人员的情况也不常见（13%），不过记录了临终讨论（90%），且通常将其列为新的护理目标（71%）。
可能改善临终护理的因素包括预先护理规划、更早认识到预后不佳以及工作人员教育。
