Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Higher Prevalence of Dementia but No Improvement in Total Comfort While Dying Among Nursing Home Residents With Dementia Between 2010 and 2015: Results From Two Retrospective Epidemiological Studies

Version 1 : Received: 30 December 2020 / Approved: 31 December 2020 / Online: 31 December 2020 (13:16:03 CET)

A peer-reviewed article of this Preprint also exists.

Miranda, R.; Smets, T.; Van Den Noortgate, N.; Deliens, L.; Block, L.V. Higher Prevalence of Dementia but No Change in Total Comfort While Dying among Nursing Home Residents with Dementia between 2010 and 2015: Results from Two Retrospective Epidemiological Studies. Int. J. Environ. Res. Public Health 2021, 18, 2160. Miranda, R.; Smets, T.; Van Den Noortgate, N.; Deliens, L.; Block, L.V. Higher Prevalence of Dementia but No Change in Total Comfort While Dying among Nursing Home Residents with Dementia between 2010 and 2015: Results from Two Retrospective Epidemiological Studies. Int. J. Environ. Res. Public Health 2021, 18, 2160.

Journal reference: Int. J. Environ. Res. Public Health 2021, 18, 2160
DOI: 10.3390/ijerph18042160

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 23%-point increase in dementia prevalence (P-value<0.001), with a total of 11%-point decrease in severe to very severe cognitive impairment (P=0.04). Controlling for this difference in resident characteristics, in the last week of life, there were increases in the use of pain assessment (+20%-point; P<0.001) and assistance with eating and drinking (+10%-point; P=0.02) but no change in total comfort. The higher prevalence of dementia in nursing homes with no improvement in residents’ total comfort while dying emphasize 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.

Subject Areas

Long-term care; care homes; nursing homes; dementia; quality improvement; palliative care

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