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Palliative care in the oldest of old in the Dutch community: a nationwide study.
Abarshi, E., Echteld, M.A., Block, L. van den, Donker, G.A., Onwuteaka-Philipsen, B., Deliens, L. Palliative care in the oldest of old in the Dutch community: a nationwide study. Palliative Medicine: 2010, 24(4 suppl.), p. S 202. Abstract. 6th Research Congress of European Association for Palliative Care. 10-12 juni 2010, Glasgow.
Aim: Provision of adequate care for the oldest of old has become more important given current ageing trends, but only few studies address palliative care in this age group. This study aims to explore differences between the oldest (85y) and younger old (65-84y), test the hypothesis that age is an independent predictor of palliative care received, and examine factors associated with receiving palliative care. We studied palliative care by focussing on provision of specialised multidisciplinary palliative care services (SPCS), palliative-centred treatment goal, and dying in a preferred place. Methods: GPs participating in the nation-wide representative sentinel network in the Netherlands were asked to fill in patient, illness and care characteristics of all patients who died non-suddenly in their practices between 2005 and 2008 of patients older than 65y, using standardised forms. Associations with the palliative care variables were tested using multiple logistic regression analyses. Results: 990 patients were registered. Amongst the oldest old, there were more women than men, more patients with heart failure than cancer, less hospital and home deaths, and more care home deaths compared with the younger old. Of the oldest patients, fewer received SPCS, fewer preferred to die at home and more preferred to die in a care home than of the younger old. Age appears to be an independent factor associated with palliative care provided: compared with the younger group, the oldest patient group received SPCS less often (OR=0.7), treatment with a palliative care aim more often (OR=2.4), and died in a preferred place more often (OR=2.0), independent of other patient, illness, and treatment characteristics. Conclusion: This study shows that age, amongst other characteristics, independently predicts the provision of palliative care in the Dutch community. Causes of this finding are yet to be explored. (aut. ref.)
Aim: Provision of adequate care for the oldest of old has become more important given current ageing trends, but only few studies address palliative care in this age group. This study aims to explore differences between the oldest (85y) and younger old (65-84y), test the hypothesis that age is an independent predictor of palliative care received, and examine factors associated with receiving palliative care. We studied palliative care by focussing on provision of specialised multidisciplinary palliative care services (SPCS), palliative-centred treatment goal, and dying in a preferred place. Methods: GPs participating in the nation-wide representative sentinel network in the Netherlands were asked to fill in patient, illness and care characteristics of all patients who died non-suddenly in their practices between 2005 and 2008 of patients older than 65y, using standardised forms. Associations with the palliative care variables were tested using multiple logistic regression analyses. Results: 990 patients were registered. Amongst the oldest old, there were more women than men, more patients with heart failure than cancer, less hospital and home deaths, and more care home deaths compared with the younger old. Of the oldest patients, fewer received SPCS, fewer preferred to die at home and more preferred to die in a care home than of the younger old. Age appears to be an independent factor associated with palliative care provided: compared with the younger group, the oldest patient group received SPCS less often (OR=0.7), treatment with a palliative care aim more often (OR=2.4), and died in a preferred place more often (OR=2.0), independent of other patient, illness, and treatment characteristics. Conclusion: This study shows that age, amongst other characteristics, independently predicts the provision of palliative care in the Dutch community. Causes of this finding are yet to be explored. (aut. ref.)
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