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Characteristics and End-of-Life Care Pathways of Decedents From a National Cohort of Assisted Living Residents.
Belanger, Emmanuelle; Rosendaal, Nicole; Wang, Xiao Joyce; Teno, Joan M; Gozalo, Pedro L; Dosa, David; Thomas, Kali S.
Afiliação
  • Belanger E; Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI.
  • Rosendaal N; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.
  • Wang XJ; Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI.
  • Teno JM; Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI.
  • Gozalo PL; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.
  • Dosa D; Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI.
  • Thomas KS; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.
Med Care ; 62(2): 125-130, 2024 Feb 01.
Article em En | MEDLINE | ID: mdl-38054851
BACKGROUND: Assisted living (AL) is an increasingly common, place of care for dying persons. However, it remains unclear to what extent residents are able to age in place or if AL represents an additional transition before death. OBJECTIVES: Examine the sociodemographic characteristics, comorbidities, health care utilization, and end-of-life care pathways of AL residents before death. RESEARCH DESIGN: A national cohort study of fee-for-service Medicare beneficiaries residing in large AL communities (25+ beds) during the month of January 2017 with 3 years of follow-up, using administrative claims data. SUBJECTS: 268,812 AL residents. MEASURES: Sociodemographic characteristics, comorbidities, and health care utilization at the end of life. RESULTS: Between 2017 and 2019, 35.1% of the study cohort died. Decedents were more likely than the overall AL population to be 85 years old or older (76.5% vs. 59.5%), and diagnosed with Alzheimer's disease and related dementia (70.3% vs. 51.6%). Most decedents (96.2%) had some presence in AL during the last year of life, but over 1 in 5 left AL before the last month of life. Among those in AL on day 30 before death, nearly half (46.4%) died in place without any health care transition, while 13.2% had 3 or more transfers before dying. CONCLUSIONS: AL is an important place of care for dying persons, especially for those with dementia. These findings indicate a need to assess existing policies and processes guiding the care of the frail and vulnerable population of dying AL residents.
Assuntos

Texto completo: 1 Temas: ECOS / Aspectos_gerais Bases de dados: MEDLINE Assunto principal: Assistência Terminal / Cuidados Paliativos na Terminalidade da Vida / Transição para Assistência do Adulto Limite: Aged / Aged80 / Humans País/Região como assunto: America do norte Idioma: En Revista: Med Care Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Temas: ECOS / Aspectos_gerais Bases de dados: MEDLINE Assunto principal: Assistência Terminal / Cuidados Paliativos na Terminalidade da Vida / Transição para Assistência do Adulto Limite: Aged / Aged80 / Humans País/Região como assunto: America do norte Idioma: En Revista: Med Care Ano de publicação: 2024 Tipo de documento: Article