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Trajectories of care home residents during the last month of life: the case of France

Published online by Cambridge University Press:  14 October 2015

SOPHIE PENNEC ,
JOELLE GAYMU ,
ELISABETH MORAND ,
FRANCOISE RIOU ,
SILVIA PONTONE ,
REGIS AUBRY  and
CHANTAL CASES
SOPHIE PENNEC*
Affiliation:
Institut National D'Études Démographiques, Paris, France. Australian Demographic and Social Research Institute, Canberra, Australia.
JOELLE GAYMU
Affiliation:
Institut National D'Études Démographiques, Paris, France.
ELISABETH MORAND
Affiliation:
Institut National D'Études Démographiques, Paris, France.
FRANCOISE RIOU
Affiliation:
CHU Pontchaillou, Rennes, France. Department of Medicine, University of Rennes I, France.
SILVIA PONTONE
Affiliation:
Institut National D'Études Démographiques, Paris, France. CHU Robert Debré, AH-HP, Paris, France.
REGIS AUBRY
Affiliation:
CHU Jean Minjoz, Besançon, France. Observatoire national de la fin de vie, Paris, France.
CHANTAL CASES
Affiliation:
Institut National D'Études Démographiques, Paris, France.
*
Address for correspondence: Sophie Pennec, Institut National D'Études Démographiques [French Institute for Demographic Studies], 133 Boulevard Davout, 75980 Paris Cedex 20, France. E-mail: [email protected]
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Abstract

This paper examines some demographic and medical factors associated with the likelihood of residing in a care home during the last month of life for persons aged 70 and over in France and, if so, of remaining in the care home throughout or being transferred to hospital. The data are from the Fin de vie en France (End of Life in France) survey undertaken in 2010. During the last month of life, very old people are more likely to be living in a care home but are not less likely to be transferred to hospital. Medical conditions and residential trajectories are closely related. People with dementia or mental disorders are more likely to live in a care home and, if so, to stay there until they die. Compared to care homes, a more technical and medication-based approach is taken in hospitals and care home residents who are transferred to hospital more often receive medication while those remaining in care homes more often receive support from a psychologist. In hospitals as in care homes, few older persons had recourse to advance directives and hospice programmes were not widespread. Promoting these two factors may help to increase the quality of end of life and facilitate an ethical approach to end-of-life care.

Keywords

end-of-life carecare homehospitalresidential trajectoriesFrench End of Life survey
Type
Articles
Information
Ageing & Society , Volume 37 , Issue 2 , February 2017 , pp. 325 - 351
Copyright
Copyright © Cambridge University Press 2015 

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