Place of Death of Geriatric Population in Turkey: A 7-Year Observational Study

2021 ◽  
pp. 082585972110365
Author(s):  
Serdar Ceylan ◽  
Merve Guner Oytun ◽  
Arzu Okyar Bas ◽  
Zeynep Kahyaoglu ◽  
Burcu B. Dogu ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
University Hospital ◽  
Place Of Death ◽  
Public Health Issue ◽  
Hospital Death ◽  
Chronic Obstructive ◽  
Life Care ◽  
Geriatric Population ◽  
Significant Difference

Background End-of-life care has become an important public health issue in recent years. Place of death is a major component of end-of-life care. Despite attempts to improve end-of-life care, there has not been published any data about place of deaths in Turkey. Aim: This retrospective, cross-sectional study investigates the place of death and trends over the years in geriatric age groups in Turkey. Methods: Patients who were admitted to geriatric outpatient clinic of a university hospital during a 7-year period were included. Place and date of death information were received from the death notification system and recorded as hospital or out-of-hospital death. Demographic and clinical data were collected from the hospital information system. Deaths occurring after March 1, 2020 were not included to eliminate the effect of coronavirus disease-2019 pandemic. Results: A total of 4025 (20.7%) patients were determined to be dead. Approximately three-quarters of deaths (73.0%) occurred in hospital. The number of deaths reported from nursing homes was only 13 (3.0%). Patients with dementia less frequently died in hospital, however, it was not statistically significant (12.4% vs 14.7%, P = .05). The prevalence of death in hospital was significantly higher in patients with chronic renal failure (3.1% vs 1.7%, P = .02). The presence of comorbid conditions such as heart failure, cerebrovascular disease, Parkinson's disease, chronic obstructive pulmonary disease/asthma, and cancer did not affect the place of death ( P = .24, .21, .24, .51, and .18). Out-of-hospital mortality increased with advanced age ( P < .001). No significant difference was found in the place of death over the years ( P = .41). Conclusion: To the best of our knowledge, this is the first study examining the place of death in Turkey, an aging country. Our results may help to establish policies about end-of-life care in elderly people to improve quality of life by using resources effectively.

A Tale of Two Surveys: Life-Affirming Strategy of Mortuary Improves the Quality of Bereavement Care After Hospital Death

2021 ◽  
pp. 003022282199218
Author(s):  
Tiffany W. S. Lau ◽  
Gavin S. W. Chan ◽  
H. Y. Yip ◽  
Jackie C. K. Poon ◽  
Gary K. F. Tsang ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Psychosocial Support ◽  
Positive Impact ◽  
University Hospital ◽  
Hospital Death ◽  
Life Care ◽  
Next Of Kin ◽  
Similar Survey ◽  
Bereavement Care

Background The mortuary plays an important, under-recognized role in end-of-life care. A ‘ Life-affirming strategy’ was introduced in the mortuary of a university hospital to enhance respect for the deceased and next-of-kin (NOK). Design: NOK who collected bodies in the mortuary of a university hospital participated in a survey. The satisfaction scores, needs and expectations were compared with a similar survey from 2015. Results: The overall experience for NOK improved significantly compared with 2015. The greatest improvement was achieved in ‘mortuary environment’, ‘attitude of mortuary staff’ and ‘body viewing arrangement in the mortuary’. The perceived need for additional psychosocial support was significantly reduced. Conclusions: Results demonstrate success of the life-affirming strategy in enhancing end-of-life care for bereaved families. The person-centered approach modernizes and professionalizes mortuary services, with a positive impact on the deceased, NOK, mortuary staff, hospital administration and wider community.

Advance care planning and place of death, hospitalisation and actual place of death in lung, heart and cancer disease: a randomised controlled trial

2019 ◽  
Vol 10 (4) ◽  
pp. e37-e37 ◽  
Author(s):  
Marianne Hjorth Skorstengaard ◽  
Anders Bonde Jensen ◽  
Pernille Andreassen ◽  
Trine Brogaard ◽  
Elisabeth Brendstrup ◽  
...  
Keyword(s):  
Usual Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Place Of Death ◽  
Life Care ◽  
Significant Difference ◽  
Advance Care ◽  
Randomised Controlled

ObjectivesAdvance care planning (ACP) can be a way to meet patients’ end-of-life preferences and enhance awareness of end-of-life care. Thereby it may affect actual place of death (APOD) and decrease the rate of hospitalisations. The aim was to investigate if ACP among terminally ill patients with lung, heart and cancer diseases effects fulfilment of preferred place of death (PPOD), amount of time spent in hospital and APOD.MethodsThe study was designed as a randomised controlled trial. Patients were assessed using general and disease-specific criteria and randomised into groups: one received usual care and one received usual care plus ACP. The intervention consisted of a discussion between a healthcare professional, the patient and their relatives about preferences for end-of-life care. The discussion was documented in the hospital file.ResultsIn total, 205 patients were randomised, of which 111 died during follow-up. No significant differences in fulfilment of PPOD (35% vs 52%, p=0.221) or in amount of time spent in hospital among deceased patients (49% vs 23%, p=0.074) were found between groups. A significant difference in APOD was found favouring home death in the intervention group (17% vs 40%, p=0.013).ConclusionConcerning the primary outcome, fulfilment of PPOD, and the secondary outcome, time spent in hospital, no differences were found. A significant difference concerning APOD was found, as more patients in the intervention group died at home, compared with the usual care group.Trial registration numberNCT01944813.

Sexuality

2015 ◽  
pp. 410-421
Author(s):  
Marianne Matzo
Keyword(s):  
Sexual Health ◽  
End Of Life ◽  
Sexual Functioning ◽  
End Of Life Care ◽  
Life Care ◽  
Leading Role ◽  
Significant Difference ◽  
The One

Healthcare practitioners should assume a leading role in the assessment and remediation of potential or identified alterations in sexual functioning. Not all couples will be concerned about their sexual health at this point of their life together. However, people may find that being physically close to the one they love is life-affirming and comforting. Assessment of sexual health should occur for all patients to determine whether these needs and hopes include maintenance of their sexual health. The healthcare practitioner’s offer of information and support can make a significant difference in a couple’s ability to adjust to the changes in sexual health during end-of-life care.

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