An Investigation of Hospital Care received prior to Death among Nursing Home Transfers with Dementia in Japan

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  • 介護老人福祉施設入所者の終末期の現状 : 老人病院入院後死亡までのカルテ調査より
  • カイゴ ロウジン フクシ シセツ ニュウショシャ ノ シュウマツキ ノ ゲンジョウ ロウジン ビョウイン ニュウイン ゴ シボウ マデ ノ カルテ チョウサ ヨリ

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Despite growing consensus that palliative end-of-life care should be provided in the nursing home setting to residents with Alzheimer's and other dementias, many nursing home residents with dementia in Japan continue to be transferred to hospitals during the terminal phase of their illness. The present study investigated all nursing home transfers of patients with dementia who were discharged as dead at a 180 bed geriatric hospital in a major metropolitan area in southern Japan over a one year period (n=33). Ages ranged from 69-100 years (mean 88.2 years). 78.8% of transfers were women. As this hospital 75.8% of transfers died within 30 days of admission. The main causes of death were pneumonia (42.4%) and heart failure (21.2%). 66.7% of transfers were listed as independent in feeding ability by the nursing home. The amount of IV fluid administered was significantly related to whether or not patient received suctioning. Although 48.5% of residents had a nursing note reporting pain only 9.1% received pain medication. 72% of patients received cardiac monitoring and 66.6% received O_2 therapy. 84.8% received antibiotics. A family member was present at 45.5% of the deaths. The findings highlight the growing need for palliative care services.

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