生命末期的结果是否因辅助生活记忆护理指定而有所不同?
Xiao Joyce Wang1, Portia Y Cornell1,2, Emmanuelle Belanger1
1Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA.
Journal of the American Geriatrics Society
|April 3, 2024
概括
记忆护理辅助生活设施 (RC/AL) 的居民死亡率和临终关怀使用率更高. 这表明,记忆护理可能会为接近生命终点的个体提供服务,或鼓励临终关怀的利用.
科学领域:
- 老年学是指老年学的学科.
- 抚慰性护理是一种缓解性护理.
- 痴呆症护理 痴呆症护理 痴呆症护理
背景情况:
- 住院护理/辅助生活 (RC/AL) 是对阿尔茨海默病和相关痴呆症 (ADRD) 患者的终身护理的日益增长的环境.
- 在22%的RC/AL中存在专门的记忆护理单位,满足独特的ADRD需求.
- 了解记忆护理与一般RC/AL的终身结果差异对于支持现场衰老至关重要.
研究的目的:
- 为了比较ADRD居民在记忆护理RC/AL和一般RC/AL之间的生命终结结果.
- 检查死亡率,临终关怀利用率和临终关怀持续时间的差异.
主要方法:
- 一项针对15152名Medicare受益人进行的前性队列研究,研究人员从2016年至2018年期间,患有ADRD过渡到大型RC/AL (≥25张床位).
- 使用逆概率治疗权重来控制基线差异.
- 两部分模型分析了生命最后一个月住宿日的差异.
主要成果:
- 记忆护理RC/AL居民的调整后死亡率高出1.3个百分点 (p=0.04).
- 在记忆护理RC/AL (p=0.01) 中,临终关怀使用率高出1.4个百分点.
- 在记忆护理RC/AL中的死者在生命的最后一个月接受了大约1.4天的临终关怀 (p=0.02).
结论:
- 记忆护理RC/AL设置与较高的死亡率和ADRD患者住院使用增加有关.
- 这些发现可能表明,记忆护理单位吸引了临终患者.
- 另外,专业的记忆护理可以促进或促进终身临终关怀的利用.
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