Dying with behavioral and psychological symptoms of dementia in Australian nursing homes: a retrospective case-control study.

Roach, P; Lovell, MR; Macfarlane, S

Dying with behavioral and psychological symptoms of dementia in Australian nursing homes: a retrospective case-control study.

Roach, P Lovell, MR Macfarlane, S

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Publisher:: Frontiers
Publication Type:: Journal Article
Citation:: Front Psychiatry, 2023, 14, pp. 1091771
Issue Date:: 2023

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Field	Value	Language
dc.contributor.author	Roach, P
dc.contributor.author	Lovell, MR
dc.contributor.author	Macfarlane, S
dc.date.accessioned	2023-11-07T04:12:19Z
dc.date.available	2023-04-27
dc.date.available	2023-11-07T04:12:19Z
dc.date.issued	2023
dc.identifier.citation	Front Psychiatry, 2023, 14, pp. 1091771
dc.identifier.issn	1664-0640
dc.identifier.issn	1664-0640
dc.identifier.uri	http://hdl.handle.net/10453/173191
dc.description.abstract	OBJECTIVES: To identify predictors of mortality in people with active and challenging behavioral and psychological symptoms of dementia (BPSD). DESIGN: A retrospective case-control study was designed to compare those referred to Dementia Support Australia (DSA) who died in the 12 months to November 2016, with an equal number of controls who did not die. An audit tool was designed after literature review and expert opinion from the service. Odds ratio calculations and the Mann-Whitney U test were used to assess for difference. SETTING: Residents of Australian residential aged care facilities with BPSD referred to the DSA service. PARTICIPANTS: Of 476 patients referred to DSA during the study period, 44 died. 44 controls were randomly selected from those remaining matched for age and sex. RESULTS: Significant differences included higher rates of benzodiazepine use, drowsiness, delirium, reduced oral intake and discussions about goals of care in those who died. Those who died were referred to the service for a shorter period and had more frequent contact between DSA and nurses at the nursing homes. Increase in opioid use and loss of skin integrity in those who died approached significance. The overall end of life course demonstrated a complex set of needs with frequent delirium, pain and frailty. CONCLUSION: Further study is required to determine the optimal care for those with BPSD at the end of their lives. This study would indicate complex end of life care needs and point to a role for palliative care support.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Frontiers
dc.relation.ispartof	Front Psychiatry
dc.relation.isbasedon	10.3389/fpsyt.2023.1091771
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services, 1701 Psychology
dc.subject.classification	3202 Clinical sciences
dc.title	Dying with behavioral and psychological symptoms of dementia in Australian nursing homes: a retrospective case-control study.
dc.type	Journal Article
utslib.citation.volume	14
utslib.location.activity	Switzerland
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1701 Psychology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-07T04:12:18Z
pubs.publication-status	Published online
pubs.volume	14

Abstract:

OBJECTIVES: To identify predictors of mortality in people with active and challenging behavioral and psychological symptoms of dementia (BPSD). DESIGN: A retrospective case-control study was designed to compare those referred to Dementia Support Australia (DSA) who died in the 12 months to November 2016, with an equal number of controls who did not die. An audit tool was designed after literature review and expert opinion from the service. Odds ratio calculations and the Mann-Whitney U test were used to assess for difference. SETTING: Residents of Australian residential aged care facilities with BPSD referred to the DSA service. PARTICIPANTS: Of 476 patients referred to DSA during the study period, 44 died. 44 controls were randomly selected from those remaining matched for age and sex. RESULTS: Significant differences included higher rates of benzodiazepine use, drowsiness, delirium, reduced oral intake and discussions about goals of care in those who died. Those who died were referred to the service for a shorter period and had more frequent contact between DSA and nurses at the nursing homes. Increase in opioid use and loss of skin integrity in those who died approached significance. The overall end of life course demonstrated a complex set of needs with frequent delirium, pain and frailty. CONCLUSION: Further study is required to determine the optimal care for those with BPSD at the end of their lives. This study would indicate complex end of life care needs and point to a role for palliative care support.

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http://hdl.handle.net/10453/173191