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    Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland.

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    Authors
    Afzal, Neelam
    Buhagiar, Kurt
    Flood, Joanne
    Cosgrave, Mary
    Affiliation
    Department of Psychiatry, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
    Issue Date
    2011-04-05T10:08:14Z
    MeSH
    Aged
    Decision Making
    Dementia
    Female
    Hospitalization
    Humans
    Ireland
    Male
    Neuropsychological Tests
    Palliative Care
    Patient Admission
    Quality of Life
    Questionnaires
    Retrospective Studies
    Severity of Illness Index
    Terminal Care
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    Citation
    Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland., 32 (2):141-6 Gen Hosp Psychiatry
    Journal
    General hospital psychiatry
    URI
    http://hdl.handle.net/10147/127087
    DOI
    10.1016/j.genhosppsych.2009.10.003
    PubMed ID
    20302987
    Abstract
    To examine the quality of end-of-life care received by patients with and without dementia on acute medical wards during their final hospitalization.
    A retrospective clinical case note review of patients aged over 65 who had died on acute medical wards within a 6-month period in a general hospital in Dublin was conducted. Seventy-five multidisciplinary clinical notes were available for scrutiny in order to identify cognitive status, measure the frequency of invasive procedures undertaken and examine the quality of palliative care as benchmarked with the Liverpool Care Pathway for the Dying Patient (LCP) program. Comparison between patients with and without dementia was made.
    Eighteen (24.0%) subjects had dementia, 32 (42.7%) subjects were described as "cognitively intact" and 25 subjects did not have reference to cognitive status. Of the 50 patients with known cognitive status, 27 (54.0%) had had a Mini Mental State Examination (MMSE) conducted (10 dementia vs. 17 nondementia). Patients were equally subjected to invasive interventions regardless of their cognitive status. However, dementia patients were significantly less likely to be referred to palliative care interventions (P=.007), to be prescribed palliative drugs (P=.017) and to have carers involved in decision making (P=.006).
    Individuals with dementia may be receiving different end-of-life care from those without. The effective delivery of robust multidisciplinary frameworks for the palliation of symptoms of hospitalized dementia patients remains an important clinical goal.
    Item Type
    Article
    Language
    en
    ISSN
    1873-7714
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.genhosppsych.2009.10.003
    Scopus Count
    Collections
    Beaumont Hospital

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