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Quality of dying of nursing home residents with dementia as judged by relatives

Published online by Cambridge University Press:  05 June 2013

Nicole van Uden ,
Lieve Van den Block ,
Jenny T. van der Steen ,
Bregje D. Onwuteaka-Philipsen ,
An Vandervoort ,
Robert Vander Stichele  and
Luc Deliens
Nicole van Uden
Affiliation:
End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
Lieve Van den Block*
Affiliation:
End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium Department of Family Medicine, Vrije Universiteit Brussel, Brussels, Belgium
Jenny T. van der Steen
Affiliation:
Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
Bregje D. Onwuteaka-Philipsen
Affiliation:
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
An Vandervoort
Affiliation:
End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
Robert Vander Stichele
Affiliation:
End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
Luc Deliens
Affiliation:
End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
*
Correspondence should be addressed to: Professor Dr. Lieve Van den Block, Laarbeeklaan 103, 1090 Jette, Brussels, Belgium. Phone: +32 (0)2/477 43 10 or (0)2/477 47 57; Fax: +32 (0)2/477 47 11. Email: [email protected].
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Abstract

Background:

Providing good quality care for the growing number of patients with dementia is a major challenge. There is little international comparative research on how people with dementia die in nursing homes. We compared the relative's judgment on quality of care at the end of life and quality of dying of nursing home residents with dementia in Belgium and the Netherlands.

Methods:

This was a Belgian cross-sectional retrospective study (2010) combined with a prospective and retrospective study from the Netherlands (January 2007–July 2011). Relatives of deceased residents of 69 Belgian and 34 Dutch nursing homes were asked to complete questionnaires. We included 190 and 337 deceased nursing home residents with dementia in Belgium and the Netherlands, respectively.

Results:

Of all identified deceased nursing home residents with dementia, respectively 53.2% and 74.8% of their relatives in Belgium and the Netherlands responded. Comfort while dying (CAD-EOLD, range 14–42) was rated better for Dutch nursing home residents than for Belgian nursing homes residents (26.1 vs. 31.1, OR 4.5, CI 1.8–11.2). We found no differences between countries regarding Satisfaction With Care (SWC-EOLD, range 10–40, means 32.5 (the Netherlands) and 32.0 (Belgium)) or symptom frequency in the last month of life (SM-EOLD, range 0–45, means 26.4 (the Netherlands) and 27.2 (Belgium)).

Conclusion:

Although nursing home structures differ between Belgium and the Netherlands, the quality of care in the last month of life for residents with dementia is similar according to their relatives. However, Dutch residents experience less discomfort while dying. The results suggest room for improved symptom management in both countries and particularly in the dying phase in Belgium.

Keywords

dementialong-term carepalliative care
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 10 , October 2013 , pp. 1697 - 1707
Copyright
Copyright © International Psychogeriatric Association 2013 

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