Hospitalization at the end of life among nursing home residents with dementia: a systematic review

Abstract Background Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figu...

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Main Authors: Falk Hoffmann, Anke Strautmann, Katharina Allers
Format: Article
Language:English
Published: BMC 2019-09-01
Series:BMC Palliative Care
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12904-019-0462-1
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author Falk Hoffmann
Anke Strautmann
Katharina Allers
author_facet Falk Hoffmann
Anke Strautmann
Katharina Allers
author_sort Falk Hoffmann
collection DOAJ
description Abstract Background Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. Methods A systematic literature search in MEDLINE, CINAHL and Scopus was conducted in May 2018. Studies were included if they reported proportions of in-hospital deaths or hospitalizations of NHR with dementia in the last month of life. Two authors independently selected studies, extracted data, and assessed quality of studies. Results Nine hundred forty-five citations were retrieved; 13 studies were included. Overall, 7 studies reported data on in-hospital death with proportions ranging between 0% in Canada and 53.3% in the UK. Studies reporting on the last 30 days of life (n = 8) varied between 8.0% in the Netherlands and 51.3% in Germany. Two studies each assessed the influence of age and sex. There seem to be fewer end-of-life hospitalizations in older age groups. The influence of sex is inconclusive. All but one study found that at the end of life residents with dementia were hospitalized less often than those without (n = 6). Conclusions We found large variations in end-of-life hospitalizations of NHR with dementia, probably being explained by differences between countries. The influence of sex and age might differ when compared to residents without dementia. More studies should compare NHR with dementia to those without and assess the influence of sex and age. Trial registration PROSPERO registration number CRD42018104263.
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spelling doaj.art-cc7382c87f4d4808897627cb1ba4ea952022-12-21T23:56:07ZengBMCBMC Palliative Care1472-684X2019-09-0118111010.1186/s12904-019-0462-1Hospitalization at the end of life among nursing home residents with dementia: a systematic reviewFalk Hoffmann0Anke Strautmann1Katharina Allers2Department of Health Services Research, Carl von Ossietzky University OldenburgDepartment of Health Services Research, Carl von Ossietzky University OldenburgDepartment of Health Services Research, Carl von Ossietzky University OldenburgAbstract Background Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. Methods A systematic literature search in MEDLINE, CINAHL and Scopus was conducted in May 2018. Studies were included if they reported proportions of in-hospital deaths or hospitalizations of NHR with dementia in the last month of life. Two authors independently selected studies, extracted data, and assessed quality of studies. Results Nine hundred forty-five citations were retrieved; 13 studies were included. Overall, 7 studies reported data on in-hospital death with proportions ranging between 0% in Canada and 53.3% in the UK. Studies reporting on the last 30 days of life (n = 8) varied between 8.0% in the Netherlands and 51.3% in Germany. Two studies each assessed the influence of age and sex. There seem to be fewer end-of-life hospitalizations in older age groups. The influence of sex is inconclusive. All but one study found that at the end of life residents with dementia were hospitalized less often than those without (n = 6). Conclusions We found large variations in end-of-life hospitalizations of NHR with dementia, probably being explained by differences between countries. The influence of sex and age might differ when compared to residents without dementia. More studies should compare NHR with dementia to those without and assess the influence of sex and age. Trial registration PROSPERO registration number CRD42018104263.http://link.springer.com/article/10.1186/s12904-019-0462-1Nursing homesDeathEnd-of-life careLong-term careHospital useHealth services research
spellingShingle Falk Hoffmann
Anke Strautmann
Katharina Allers
Hospitalization at the end of life among nursing home residents with dementia: a systematic review
BMC Palliative Care
Nursing homes
Death
End-of-life care
Long-term care
Hospital use
Health services research
title Hospitalization at the end of life among nursing home residents with dementia: a systematic review
title_full Hospitalization at the end of life among nursing home residents with dementia: a systematic review
title_fullStr Hospitalization at the end of life among nursing home residents with dementia: a systematic review
title_full_unstemmed Hospitalization at the end of life among nursing home residents with dementia: a systematic review
title_short Hospitalization at the end of life among nursing home residents with dementia: a systematic review
title_sort hospitalization at the end of life among nursing home residents with dementia a systematic review
topic Nursing homes
Death
End-of-life care
Long-term care
Hospital use
Health services research
url http://link.springer.com/article/10.1186/s12904-019-0462-1
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