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Hospitals 'failing to deliver' appropriate end-of-life care to dementia patients

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Many patients with dementia who die in hospital still fail to receive sufficiently structured end of life care, a study in the North West has suggested.

Researchers at Manchester Royal Infirmary tracked the experiences of 32 patients with dementia who were admitted from nursing or care homes and died in the hospital over a 12 month period.

They investigated whether the national Gold Standards Framework (GSF) for end of life care was useful in predicting death and whether tools such as advanced care planning or treatment pathways were used.

The authors concluded that while two thirds of the patients demonstrated characteristics of end stage dementia, the GSF was not accurate in predicting death.

They added that an end of life pathway was implemented for 75% of patients, but there was “little evidence” of advance care planning. In addition, 78% of the sample was “subject to burdensome interventions”, the authors said.

“The findings suggest that end stage dementia could be better recognised and questions are raised about appropriate end of life care in patients dying with dementia in the acute setting,” they said.

The findings were presented on Tuesday at the Royal College of Nursing’s international research conference in London.

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Readers' comments (2)

  • May I suggest the structure of care is not the problem.
    My mother who had severe dementia was transferred from her nursing home to an acute ward in a General Hospital at the end of her life. I feel an old dog would have been treated more humanely, not necessarily because of the framework of care but because of the law.
    In my opinion an acute ward is not a suitable place for anyone to die.

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  • I did everything within my power to prevent my father from being admitted to hospital from his totally appropriate nursing home bed during his end stage dementia, as on occasions his 'apparent' condition during the night gave some cause for concern which, along with system failures could have led to several inappropriate admissions and lots of distress to both him and our family.
    I take comfort in the fact that my father died in a peacful and dignified manner, surrounded each day by his close family and that I spent 4 nights at his side. Something I know would never have happened in a hospital setting, acute or community.

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