Residential aged care residents and components of end of life care in an Australian hospital
Residential aged care residents and components of end of life care in an Australian hospital
Blog Article
Abstract Background With ageing of Australians, the numbers of residential aged care (RAC) residents is rising.This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care.The aim was to study a sample Seromolecular study on the prevalence and risk factors of Toxoplasma gondii infection in pregnant women referred to a gynecology hospital in Urmia, northwest part of Iran in 2022 of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required.Methods A retrospective case-note review of hospital records was conducted in Adelaide, Australia.Participants were 109 RAC residents who attended from July 2013 to June 2014 and died in hospital.
Measurements were advance care planning, health care input from the RAC facilities to hospital and components of EOL care.Residents with and without advanced dementia were compared.Results Advance care directives (ACDs) were present from 11 to 50%, and advance care plans (ACPs) at 60%.There were more ACPs, resuscitation orders (for/against) and do-not-hospitalise orders in residents with advanced dementia than those without.General practitioner (GP) and extended care paramedic (ECP) input on decisions for hospital transfer were 30% and 1 %.
Mean hospital stay to death was 5.2 days.For residents admitted under non-palliative care teams, specialist palliative care (copyright) was needed for phone advice in 5%, consultation in 45%, transfer to palliative care unit in 37%, and takeover by copyright team An Exploration of the Raya Dunayevskaya Collection – Marxist-Humanism: A Half-Century of its World Development in 19%.Mean number of documented goals-of-care discussions with family/caregiver was 1.7.
In the last 3 days of life, the mean daily number of doses of EOL medications was 4.2.Continuous subcutaneous infusion was commenced in 35%.Conclusion Staff in RAC need to be adequately resourced to make complex decisions about whether to transfer to hospital.RAC nurses are mainly making these decisions as GP and ECP input were suboptimal.
Ways to support nurses and optimise decision-making are needed.Advance care planning can be improved, especially documentation of EOL wishes and hospitalisation orders.By describing the components of EOL care, it is hoped providers and policy makers have more information to assist with making decisions about what is the most appropriate care for this population.