End-of-life care and preferences for place of death among the oldest old: results of a population-based survey using VOICES–Short form
End-of-life care and preferences for place of death among the oldest old: results of a population-based survey using VOICES–Short form
Background: End-of-life care (EOLC) is a key component in care of older people. However, evidence suggests that the oldest old (>85 years) are less likely to access specialist EOLC.
Objective: The study's objective was to explore experiences of EOLC among the oldest old and determine their reported preference for place of death.
Design: The study involved a self-completion postbereavement survey.
Methods: A census was taken of deaths registered between October 2009 and April 2010 in two health districts, identified from death certificates. Views of Informal Carers-Evalution of Service (VOICES)–Short Form was sent to each informant (n=1422, usually bereaved relative) 6 to 12 months after the death.
Results: Of 473 (33%) who responded, 48% of decedents were age 85 or over. There were no age differences in reported care quality in the last three months, but in the last two days the oldest old were reported to receive poorer relief of nonpain symptoms and less emotional and spiritual support. Compared to people under age 85, the over 85s were less likely to be reported to know they were dying, to have a record of their preferences for place of death, to die in their preferred place, to have enough choice about place of death—and more likely to be reported to have had unwanted treatment decisions. Being over 85 years was associated with a reduction in the odds of home death (OR=0.36); failure to ascertain and record preference for place of death contributed to this.
Conclusions: Age-associated disparity exists in care provided in the last two days and the realization of preferences.
176-182
Hunt, Katherine J.
5eab8123-1157-4d4e-a7d9-5fd817218c6e
Shlomo, Natalie
28c0e3f9-0a35-4939-af90-8a897b9b6017
Addington-Hall, Julia
87560cc4-7562-4f9b-b908-81f3b603fdd8
11 February 2014
Hunt, Katherine J.
5eab8123-1157-4d4e-a7d9-5fd817218c6e
Shlomo, Natalie
28c0e3f9-0a35-4939-af90-8a897b9b6017
Addington-Hall, Julia
87560cc4-7562-4f9b-b908-81f3b603fdd8
Hunt, Katherine J., Shlomo, Natalie and Addington-Hall, Julia
(2014)
End-of-life care and preferences for place of death among the oldest old: results of a population-based survey using VOICES–Short form.
Journal of Palliative Medicine, 17 (2), .
(doi:10.1089/jpm.2013.0385).
(PMID:24438096)
Abstract
Background: End-of-life care (EOLC) is a key component in care of older people. However, evidence suggests that the oldest old (>85 years) are less likely to access specialist EOLC.
Objective: The study's objective was to explore experiences of EOLC among the oldest old and determine their reported preference for place of death.
Design: The study involved a self-completion postbereavement survey.
Methods: A census was taken of deaths registered between October 2009 and April 2010 in two health districts, identified from death certificates. Views of Informal Carers-Evalution of Service (VOICES)–Short Form was sent to each informant (n=1422, usually bereaved relative) 6 to 12 months after the death.
Results: Of 473 (33%) who responded, 48% of decedents were age 85 or over. There were no age differences in reported care quality in the last three months, but in the last two days the oldest old were reported to receive poorer relief of nonpain symptoms and less emotional and spiritual support. Compared to people under age 85, the over 85s were less likely to be reported to know they were dying, to have a record of their preferences for place of death, to die in their preferred place, to have enough choice about place of death—and more likely to be reported to have had unwanted treatment decisions. Being over 85 years was associated with a reduction in the odds of home death (OR=0.36); failure to ascertain and record preference for place of death contributed to this.
Conclusions: Age-associated disparity exists in care provided in the last two days and the realization of preferences.
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e-pub ahead of print date: 17 January 2014
Published date: 11 February 2014
Organisations:
Faculty of Health Sciences
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Local EPrints ID: 361480
URI: http://eprints.soton.ac.uk/id/eprint/361480
ISSN: 1096-6218
PURE UUID: 16cb9577-f15d-4cf0-8f76-0a53f637e42a
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Date deposited: 23 Jan 2014 14:40
Last modified: 25 Jun 2024 01:43
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Author:
Natalie Shlomo
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