BACKGROUND: Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce. AIM: To examine the place of residence or care of > or =85 year-olds less than a year before death, and their place of death, and to map individual changes between the two. DESIGN OF STUDY: Population-based cohort study. SETTING: Cambridge City over-75s Cohort (CC75C) study, UK. METHOD: Retrospective analysis of prospective data from males and females aged > or =85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage. RESULTS: Only 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes. CONCLUSION: More than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old.
BACKGROUND: Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce. AIM: To examine the place of residence or care of > or =85 year-olds less than a year before death, and their place of death, and to map individual changes between the two. DESIGN OF STUDY: Population-based cohort study. SETTING: Cambridge City over-75s Cohort (CC75C) study, UK. METHOD: Retrospective analysis of prospective data from males and females aged > or =85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage. RESULTS: Only 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes. CONCLUSION: More than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old.
Authors: Cathy Shipman; Marjolein Gysels; Patrick White; Allison Worth; Scott A Murray; Stephen Barclay; Sarah Forrest; Jonathan Shepherd; Jeremy Dale; Steve Dewar; Marilyn Peters; Suzanne White; Alison Richardson; Karl Lorenz; Jonathan Koffman; Irene J Higginson Journal: BMJ Date: 2008-10-01
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Authors: Yu-Tzu Wu; A Matthew Prina; Linda E Barnes; Fiona E Matthews; Carol Brayne Journal: J Public Health (Oxf) Date: 2015-04-28 Impact factor: 2.341
Authors: Yu-Tzu Wu; A Matthew Prina; Andrew P Jones; Linda E Barnes; Fiona E Matthews; Carol Brayne Journal: Age Ageing Date: 2015-10-13 Impact factor: 10.668
Authors: Yu-Tzu Wu; A Matthew Prina; Andy Jones; Linda E Barnes; Fiona E Matthews; Carol Brayne Journal: Health Place Date: 2016-02-01 Impact factor: 4.078