Evidence map›Paper›PMID 38195437›Full record

ArticleBMC geriatrics2024

What care do people with dementia receive at the end of life? Lessons from a retrospective clinical audit of deaths in hospital and other settings.

Zoi Triandafilidis, Sally Carr, Daneill Davis, Simon Chiu, Lucy Leigh, Sarah Jeong, Daniel Wong, Jacinta Hensby, Suzanne Lewis, John Attia and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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

11 authors at 5 institutions in 1 country.

Zoi TriandafilidisCentral Coast Research Institute (CCRI) for Integrated Care, Gosford, NSW, Australia. zoi.triandafilidis@health.nsw.gov.au.
Sally CarrCentral Coast Local Health District, Gosford, NSW, Australia.
Daneill DavisCentral Coast Local Health District, Gosford, NSW, Australia.
Simon ChiuHunter Medical Research Institute, Newcastle, NSW, Australia.
Lucy LeighHunter Medical Research Institute, Newcastle, NSW, Australia.
Sarah JeongCentral Coast Local Health District, Gosford, NSW, Australia.
Daniel WongThe University of Newcastle, Gosford, NSW, Australia.
Jacinta HensbyCentral Coast Local Health District, Gosford, NSW, Australia.
Suzanne LewisCentral Coast Research Institute (CCRI) for Integrated Care, Gosford, NSW, Australia.
John AttiaThe University of Newcastle, Gosford, NSW, Australia.
Nicholas GoodwinCentral Coast Research Institute (CCRI) for Integrated Care, Gosford, NSW, Australia.
Gosford Hospital · AUCentral Coast Local Health District · AUHunter Medical Research Institute · AUNew South Wales Department of Health · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe need for better end-of-life care for people with dementia has been acknowledged. Existing literature suggests that people dying with dementia have less access to palliative care, yet little is known about the care provided to people with dementia at the end of life. This study aimed to establish evidence related to end-of-life care for people dying with dementia in hospital compared to other settings.

methodsA retrospective clinical audit of people who had a diagnosis of dementia and had accessed services within a local health district, who died between 2015 and 2019, was conducted. A total of 705 people were identified, and a subset of 299 people randomly selected for manual audit. Chi-square p-values were used to compare the place of death, and a t-test or non-parametric test was used to assess the significance of the difference, as appropriate. Measures of functional decline within one month of death were assessed using mixed effects logistic regression models.

resultsThe characteristics of people differed by place of death, with people who died in hospital more likely to be living at home and to not have a spouse. Less than 1 in 5 people had advance care directives or plans. Many were still being actively treated at the time of death: almost half of people who died in hospital had an investigation in their final 72 hours, less than half of people were coded as receiving palliative care at death, and more than 2 in 3 people did not get access to specialist palliative care. Declining function was associated with the terminal phase.

conclusionThis study provides novel insights for those providing end-of-life care for people with dementia. Healthcare professionals and policy makers should consider how demographic characteristics relate to the places people with dementia receive end-of-life care. The care provided to people with dementia in the last year of their life highlights the need for more support to prepare advance care documentation and timely consideration for palliative care. Changes in markers of nutritional status and function in people with advanced dementia may help with identification of terminal phases.

Indexed as

Clinical AuditDementiaTerminal CareHospitalsHumansRetrospective StudiesDementiaEnd of lifeMedical records reviewPalliative careQuality improvement

Identifiers

PMID38195437
PMCPMC10775581
OpenAlexW4390733006

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.