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BMC Palliative Care
Published in: BMC Palliative Care 1/2020

01-12-2020 | Care | Research article

Palliative care for nursing home patients with dementia: service evaluation and risk factors of mortality

Authors: Chih-Pang Chu, Cho-Yin Huang, Chian-Jue Kuo, Ying-Yeh Chen, Chun-Tse Chen, Tien-Wei Yang, Hsing-Cheng Liu

Published in: BMC Palliative Care | Issue 1/2020

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Abstract

Background

Difficulties in prognostication are common deterrents to palliative care among dementia patients. This study aimed to evaluate the effectiveness of palliative care in reducing the extent of utilization of medical services and the potential risk factors of mortality among dementia patients receiving palliative care.

Methods

We surveyed dementia patients involved in a palliative care program at a long-term care facility in Taipei, Taiwan. We enrolled 57 patients with advanced dementia (clinical dementia rating ≥ 5 or functional assessment staging test stage 7b). We then compared the extent of their utilization of medical services before and after the provision of palliative care. Based on multivariable logistic regression, we identified potential risk factors before and after the provision of palliative care associated with 6-month mortality.

Results

The utilization of medical services was significantly lower among dementia patients after the provision of palliative care than before, including visits to medical departments (p < 0.001), medications prescribed (p < 0.001), frequency of hospitalization (p < 0.001), and visits to the emergency room (p < 0.001). Moreover, patients dying within 6 months after the palliative care program had a slightly but not significantly higher number of admissions before receiving hospice care (p = 0.058) on univariate analysis. However, no significant differences were observed in multivariate analysis.

Conclusions

The provision of palliative care to dementia patients reduces the extent of utilization of medical services. However, further studies with larger patient cohorts are required to stratify the potential risk factors of mortality in this patient group.
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Metadata
Title
Palliative care for nursing home patients with dementia: service evaluation and risk factors of mortality
Authors
Chih-Pang Chu
Cho-Yin Huang
Chian-Jue Kuo
Ying-Yeh Chen
Chun-Tse Chen
Tien-Wei Yang
Hsing-Cheng Liu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2020
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-020-00627-9

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