Quality of dying and quality of end-of-life care of nursing home residents in six countries: An epidemiological study

Background: Nursing homes are among the most common places of death in many countries. Aim: To determine the quality of dying and end-of-life care of nursing home residents in six European countries. Design: Epidemiological survey in a proportionally stratified random sample of nursing homes. We ide...

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Published in:Palliative medicine 2018-12, Vol.32 (10), p.1584-1595
Main Authors: Pivodic, Lara, Smets, Tinne, Van den Noortgate, Nele, Onwuteaka-Philipsen, Bregje D, Engels, Yvonne, Szczerbińska, Katarzyna, Finne-Soveri, Harriet, Froggatt, Katherine, Gambassi, Giovanni, Deliens, Luc, Van den Block, Lieve
Format: Article
Language:English
Subjects:
Care assistants
Comfort
Confidence intervals
Death & dying
Dementia
End of life decisions
Epidemiology
Evaluation
Functional status
Home health care
Length of stay
Long term health care
Nursing homes
Original
Palliative care
Quality of care
Questionnaires
Research design
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Summary:Background: Nursing homes are among the most common places of death in many countries. Aim: To determine the quality of dying and end-of-life care of nursing home residents in six European countries. Design: Epidemiological survey in a proportionally stratified random sample of nursing homes. We identified all deaths of residents of the preceding 3-month period. Main outcomes: quality of dying in the last week of life (measured using End-of-Life in Dementia Scales – Comfort Assessment while Dying (EOLD-CAD)); quality of end-of-life care in the last month of life (measured using Quality of Dying in Long-Term Care (QoD-LTC) scale). Higher scores indicate better quality. Setting/participants: Three hundred and twenty-two nursing homes in Belgium, Finland, Italy, the Netherlands, Poland and England. Participants were staff (nurses or care assistants) most involved in each resident’s care. Results: Staff returned questionnaires regarding 1384 (81.6%) of 1696 deceased residents. The End-of-Life in Dementia Scales – Comfort Assessment while Dying mean score (95% confidence interval) (theoretical 14–42) ranged from 29.9 (27.6; 32.2) in Italy to 33.9 (31.5; 36.3) in England. The Quality of Dying in Long-Term Care mean score (95% confidence interval) (theoretical 11–55) ranged from 35.0 (31.8; 38.3) in Italy to 44.1 (40.7; 47.4) in England. A higher End-of-Life in Dementia Scales – Comfort Assessment while Dying score was associated with country (p = 0.027), older age (p = 0.012), length of stay ⩾1 year (p = 0.034), higher functional status (p 
ISSN:0269-2163
1477-030X
DOI:10.1177/0269216318800610