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American Journal of Hospice and Palliative Medicine®, Vol. 20, No. 3, 191-200 (2003)
DOI: 10.1177/104990910302000307
© 2003 SAGE Publications

Characteristics of dementia end-of-life care across care settings

Ladislav Volicer, MD, PhD

Geriatric Research Education Clinical Center, E. N. Rogers Memorial Veterans Hospital, Bedford, Massachusetts, Boston University School of Medicine, Boston, Massachusetts

Ann C. Hurley, RN, DNSc

Center for Excellence in Nursing Practice, Brigham and Women’s Hospital, Brookline, Massachusetts

Zuzka V. Blasi, MEd

Education Development Center, Watertown, Massachusetts

End-of-life care for persons with dementia in different care settings was retrospectively surveyed. In this sample, care recipients receiving hospice care and pain control stayed at home longer and were more likely to die at home. Psychiatric symptoms increased caregiver burden and were the most common reason for admission to an institution, and psychiatric care was associated with longer stay at home. Presence of advance directives decreased hospital stay and increased the likelihood of dying in a nursing home. Care recipients dying at home had fewer symptoms and less discomfort than care recipients dying in other settings. These results indicate that quality end-of-life care can be provided at home and is facilitated by hospice programs, effective pain control, and psychiatric care.

Key Words: dementia • end of life • home care • caregiver • hospital • nursing home


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