Author
Listed:
- Rose Miranda
(End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, 1090 Brussels, Belgium
Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium)
- Tinne Smets
(End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, 1090 Brussels, Belgium
Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium)
- Nele Van Den Noortgate
(Department of Geriatric Medicine, Ghent University Hospital, 9000 Ghent, Belgium)
- Luc Deliens
(End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, 1090 Brussels, Belgium
Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
Department of Public Health and Primary Care, Ghent University Hospital, 9000 Ghent, Belgium)
- Lieve Van den Block
(End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, 1090 Brussels, Belgium
Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium)
Abstract
Important policy developments in dementia and palliative care in nursing homes between 2010 and 2015 in Flanders, Belgium might have influenced which people die in nursing homes and how they die. We aimed to examine differences between 2010 and 2015 in the prevalence and characteristics of residents with dementia in nursing homes in Flanders, and their palliative care service use and comfort in the last week of life. We used two retrospective epidemiological studies, including 198 residents in 2010 and 183 in 2015, who died with dementia in representative samples of nursing homes in Flanders. We found a 15%-point increase in dementia prevalence ( p -value < 0.01), with a total of 11%-point decrease in severe to very severe cognitive impairment ( p = 0.04). Controlling for residents’ characteristics, in the last week of life, there was an increase in the use of pain assessment (+20%-point; p < 0.03) but no change in total comfort. The higher prevalence of dementia in nursing homes with no change in residents’ total comfort while dying emphasizes an urgent need to better support nursing homes in improving their capacities to provide timely and high-quality palliative care services to more residents dying with dementia.
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