Evidence map›Paper›PMID 31117991›Full record

ArticleBMC geriatrics2019

End of life care for long-term care residents with dementia, chronic illness and cancer: prospective staff survey.

Michal Boyd, Rosemary Frey, Deborah Balmer, Jackie Robinson, Heather McLeod, Susan Foster, Julia Slark, Merryn Gott

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Michal BoydSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand. michal.boyd@auckland.ac.nz.ORCID 0000-0002-8895-1251
Rosemary FreySchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.
Deborah BalmerSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.
Jackie RobinsonSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.
Heather McLeodSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.
Susan FosterSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.
Julia SlarkSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.
Merryn GottSchool of Nursing, The University of Auckland, Private Bag, Auckland, 92019, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle is known about the quality of end of life care in long-term care (LTC) for residents with different diagnostic trajectories. The aim of this study was to compare symptoms before death in LTC for those with cancer, dementia or chronic illness.

methodsAfter-death prospective staff survey of resident deaths with random cluster sampling in 61 representative LTC facilities across New Zealand (3709 beds). Deaths (n = 286) were studied over 3 months in each facility. Standardised questionnaires - Symptom Management (SM-EOLD) and Comfort Assessment in End of life with Dementia (CAD-EOLD) - were administered to staff after the resident's death.

resultsPrimary diagnoses at the time of death were dementia (49%), chronic illness (30%), cancer (17%), and dementia and cancer (4%). Residents with cancer had more community hospice involvement (30%) than those with chronic illness (12%) or dementia (5%). There was no difference in mean SM-EOLD in the last month of life by diagnosis (cancer 26.9 (8.6), dementia 26.5(8.2), chronic illness 26.9(8.6). Planned contrast analyses of individual items found people with dementia had more pain and those with cancer had less anxiety. There was no difference in mean CAD-EOLD scores in the week before death by diagnosis (total sample 33.7(SD 5.2), dementia 34.4(SD 5.2), chronic illness 33.0(SD 5.1), cancer 33.3(5.1)). Planned contrast analyses showed significantly more physical symptoms for those with dementia and chronic illness in the last month of life than those with cancer.

conclusionsOverall, symptoms in the last week and month of life did not vary by diagnosis. However, sub-group planned contrast analyses found those with dementia and chronic illness experienced more physical distress during the last weeks and months of life than those with cancer. These results highlight the complex nature of LTC end of life care that requires an integrated gerontology/palliative care approach.

Indexed as

Health PersonnelAgedAged, 80 and overChronic DiseaseDementiaFemaleHumansLong-Term CareMaleNeoplasmsNew ZealandNursing HomesProspective StudiesSurveys and QuestionnairesTerminal CareEnd-of-life careFrail elderlyPalliative careQuality of dyingResidential facilities

Identifiers

PMID31117991
PMCPMC6532195

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.