Evidence map›Paper›PMID 35716066›Full record

ArticleGeriatrics & gerontology international2022

Older adults' preferences for and actual situations of artificial hydration and nutrition in end-of-life care: An 11-year follow-up study in a care home.

Taizo Wada, Yasuko Ishimoto, Kiichi Hirayama, Emiko Kato, Mai Tatsuno, Michiko Fujisawa, Yumi Kimura, Yoriko Kasahara, Eriko Fukutomi, Hissei Imai and 8 more

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In one paragraph

Article in Geriatrics & gerontology international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 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

18 authors.

Taizo WadaCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0003-0486-858X
Yasuko IshimotoCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Kiichi HirayamaDepartment of Field Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Emiko KatoCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Mai TatsunoCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Michiko FujisawaCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Yumi KimuraGraduate School of Human Sciences, Osaka University, Suita, Japan.ORCID https://orcid.org/0000-0001-6427-5204
Yoriko KasaharaDivision of Human Health Sciences, Department of Fundamental Nursing, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Eriko FukutomiYoshino Town Office, Yoshino, Japan.
Hissei ImaiDepartment of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan.
Masahiro NakatsukaGifu Shotoku Gakuen University, Gifu, Japan.
Mitsuhiro NoseCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Masanori IwasakiTokyo Metropolitan Institute of Gerontology, Tokyo, Japan.ORCID https://orcid.org/0000-0002-5739-2936
Satoko KakutaDivision of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan.
Mayumi HirosakiCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Kiyohito OkumiyaCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Kozo MatsubayashiCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Ryota SakamotoCenter for Southeast Asian Studies, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0002-0774-9925

Funding

Japan Society for the Promotion of Science 19K10557The Japan Geriatrics Society JGSResearchGrantAwardinGeriatricsGerontology
6 · The paper itself

Abstract

aimTo clarify older adults' preferences for and actual situations of artificial hydration and nutrition (AHN) in end-of-life care in a care home.

methodsParticipants were residents of a care home who had completed advance directives regarding preferred methods of AHN from 2009 to 2018. Advance directives alone were available from April 2009 to June 2016 (Wave 1), and advance care planning for AHN including advance directives was introduced in July 2016 (Wave 2). AHN preferences included (i) intensive methods (percutaneous endoscopic gastrostomy, nasogastric tube feeding and total parenteral nutrition), (ii) drip infusion, and (iii) oral intake only. Participants were followed until the end of 2020, and we checked whether decisions about AHN were based on older adults' preferences.

resultsIn total, 272 participants had completed advance directives. Most participants preferred "oral intake only" (59.5%), followed by drip infusion (32.0%) and intensive methods (8.5%) in advance directives. Ninety of the 272 participants completed advance directives twice; 83.3% did not change their AHN preferences from Wave 1 to Wave 2. By the end of 2020, 93 of the 272 participants died in the care home. AHN was provided according to older adults' preferences in 48.9% (oral intake only), in 51.4% (drip infusion) and in 55.6% (intensive methods) of cases respectively.

conclusionsMost participants preferred oral intake only, and their preferences were reflected in decisions about actual situations of AHN in end-of-life care. To prepare for advanced dementia and senility, early advance care planning for AHN should be promoted. Geriatr Gerontol Int 2022; 22: 581-587.

Indexed as

Advance Care PlanningTerminal CareAdvance DirectivesAgedFollow-Up StudiesHumansIntubation, Gastrointestinaladvance care planningadvance directivesartificial hydration and nutritionend-of-life carepreferences

Identifiers

PMID35716066
PMCPMC9545872

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Registered trials

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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.