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临终关怀中百岁老人的临床现象学与特征

Clinical Phenomenology and Characteristics of Centenarians in Hospice.

作者信息

Schoonover Kimberly L, Lapid Maria I

机构信息

1 Center for Palliative Medicine, Mayo Clinic, Rochester, MN, USA.

2 Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.

出版信息

J Palliat Care. 2019 Jan;34(1):47-51. doi: 10.1177/0825859718800491. Epub 2018 Sep 19.

DOI:10.1177/0825859718800491
PMID:30229699
Abstract

OBJECTIVES

: Little is known about the hospice experience of centenarians. As the population of centenarians is projected to increase, understanding their unique end-of-life needs will be important to inform delivery of quality end-of-life care. Our objective was to characterize the hospice experience of centenarians.

METHODS

: A retrospective single-institution cohort study of centenarians enrolled in hospice from January 1, 2015, to December 31, 2017, was conducted to collect demographic and clinical information.

RESULTS

: Seventeen centenarians, who comprised 1.4% of hospice admissions, had an average age of 102 years, were mostly female (71%) and widowed (76%), and all caucasian. Upon hospice admission, centenarians resided in nursing (8, 47%) and assisted living (4, 24%) residencies as well as at home (4, 24%) and in senior independent living (1, 6%). Sixty percent of centenarians died in a nursing home. The most common hospice admission diagnosis was dementia (35%). Median length of stay on hospice was 41 days (range: 16-85) for 15 persons who died or discharged live.

CONCLUSIONS

: In this group of centenarians, dementia was the most common condition for hospice enrollment. Slightly less than half resided in nursing homes on admission, although death occurred most frequently in a nursing home. Centenarians were generally able to remain out of the hospital at their time of death.

摘要

目的

关于百岁老人的临终关怀经历,人们了解甚少。由于预计百岁老人的数量将会增加,了解他们独特的临终需求对于提供高质量的临终关怀至关重要。我们的目标是描述百岁老人的临终关怀经历。

方法

对2015年1月1日至2017年12月31日期间入住临终关怀机构的百岁老人进行回顾性单机构队列研究,以收集人口统计学和临床信息。

结果

17名百岁老人占临终关怀入院人数的1.4%,平均年龄为102岁,大多数为女性(71%)且丧偶(76%),均为白种人。入住临终关怀机构时,百岁老人居住在养老院(8人,47%)、辅助生活机构(4人,24%)、家中(4人,24%)和高级独立生活设施(1人,6%)。60%的百岁老人在养老院去世。临终关怀入院最常见的诊断是痴呆症(35%)。15名死亡或存活出院者在临终关怀机构的中位住院时间为41天(范围:16 - 85天)。

结论

在这组百岁老人中,痴呆症是临终关怀入院最常见的疾病。入院时略少于一半的人居住在养老院,尽管死亡最常发生在养老院。百岁老人在死亡时通常能够避免住院。

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