Ong Xin Wen, Le Couteur David G, Waite Louise M, Thillainadesan Janani
Department of Geriatric Medicine and Centre for Education and Research on Ageing (CERA), Concord Hospital, Concord, New South Wales, Australia.
Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
J Gerontol A Biol Sci Med Sci. 2025 Jul 24;80(8). doi: 10.1093/gerona/glaf120.
As the aging population grows, the care provided to patients with dementia at the end of life represents a critical area of geriatric and palliative care. This study aimed to describe the care provided to hospitalized patients with dementia who died during their hospital stay.
A retrospective cohort study was conducted at a teaching hospital in Sydney, Australia. The study included patients with dementia who died during hospitalization. Data were collected on demographic characteristics, clinical management, and documentation of key care processes, including advance care planning, resuscitation orders, and discussions about oral nutrition and hydration.
The study cohort comprised patients with a mean age of 87.2 ± 7.2 years (n = 100), 63% of whom had lived in nursing homes. Geriatric medicine teams cared for a large proportion of patients (63%), and their patients were more likely to be older, from a nursing home, and to die from pneumonia compared to those admitted in palliative care teams. Recommended care processes were implemented in the majority of patients with advance care planning and resuscitation orders being the most frequently documented, and discussions about oral nutrition and hydration the least frequent.
This study highlights the integral role of geriatrics services in providing end-of-life care for hospitalized patients with dementia, and underscore opportunities to enhance the quality and consistency of care for this population.
随着人口老龄化加剧，为临终痴呆患者提供的护理成为老年医学和姑息治疗的关键领域。本研究旨在描述为在住院期间死亡的痴呆住院患者提供的护理情况。
在澳大利亚悉尼的一家教学医院进行了一项回顾性队列研究。该研究纳入了在住院期间死亡的痴呆患者。收集了人口统计学特征、临床管理以及关键护理流程的记录数据，包括预先护理计划、复苏医嘱以及关于经口营养和补液的讨论。
研究队列包括平均年龄为87.2±7.2岁的患者（n = 100），其中63%曾居住在养老院。老年医学团队护理了很大比例的患者（63%），与姑息治疗团队收治的患者相比，他们的患者年龄更大，来自养老院，且更有可能死于肺炎。大多数患者实施了推荐的护理流程，预先护理计划和复苏医嘱记录最为频繁，而关于经口营养和补液的讨论记录最少。
本研究强调了老年医学服务在为住院痴呆患者提供临终护理方面的重要作用，并凸显了提高该人群护理质量和一致性的机会。
