BACKGROUND: Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. DESIGN: Cross-sectional analysis of data. SETTING: 2007 National Home and Hospice Care Survey. PARTICIPANTS: Four thousand seven hundred eleven discharges from hospice care. MEASUREMENTS: A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. RESULTS: Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). CONCLUSIONS: The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.
BACKGROUND:Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. DESIGN: Cross-sectional analysis of data. SETTING: 2007 National Home and Hospice Care Survey. PARTICIPANTS: Four thousand seven hundred eleven discharges from hospice care. MEASUREMENTS: A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. RESULTS: Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). CONCLUSIONS: The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.
Authors: A Lukas; M Schuler; T W Fischer; S J Gibson; S M Savvas; T Nikolaus; M Denkinger Journal: Z Gerontol Geriatr Date: 2012-01-27 Impact factor: 1.281
Authors: Susan L Mitchell; Dan K Kiely; Susan C Miller; Stephen R Connor; Carol Spence; Joan M Teno Journal: J Pain Symptom Manage Date: 2007-05-23 Impact factor: 3.612
Authors: Tessa van der Maaden; Simone A Hendriks; Henrica C W de Vet; Menno T Zomerhuis; Martin Smalbrugge; Elise P Jansma; Raymond T C M Koopmans; Cees M P M Hertogh; Jenny T van der Steen Journal: Drugs Aging Date: 2015-01 Impact factor: 3.923
Authors: Robin Tarter; George Demiris; Kenneth Pike; Karla Washington; Debra Parker Oliver Journal: Am J Alzheimers Dis Other Demen Date: 2016-06-14 Impact factor: 2.035
Authors: Abraham A Brody; Deborah E Barnes; Joshua Chodosh; James E Galvin; Kenneth W Hepburn; Andrea B Troxel; Kimberly Hom; Ellen P McCarthy; Kathleen T Unroe Journal: J Am Geriatr Soc Date: 2020-07 Impact factor: 5.562
Authors: Shih-Yin Lin; Catherine E Schneider; Alycia A Bristol; Maureen Clancy; Sara A Sprague; Melissa Aldridge; Tara Cortes; Keith S Goldfeld; Jean S Kutner; Susan L Mitchell; Joseph W Shega; Bei Wu; Carolyn W Zhu; Abraham A Brody Journal: Gerontologist Date: 2022-02-09
Authors: Justine S Sefcik; Elease J McLaurin; Ellen J Bass; Rose Ann DiMaria-Ghalili Journal: Int J Older People Nurs Date: 2022-01-18 Impact factor: 2.471
Authors: Maartje S Klapwijk; Monique A A Caljouw; Mirjam C van Soest-Poortvliet; Jenny T van der Steen; Wilco P Achterberg Journal: BMC Geriatr Date: 2014-09-02 Impact factor: 3.921