title: Hospice care in a cohort of elders with dementia and mild cognitive impairment.
abstract: The objectives of this study were to identify the characteristics associated with hospice enrollment, to determine whether enrollment in hospice was associated with less pain and psychiatric symptoms, and to assess caregiver satisfaction with care near death in a sample of patients with dementia and mild cognitive impairment (MCI). Participants included decedents with dementia or MCI and other medical illnesses whose deaths were expected (n = 81) during a 3-year prospective, longitudinal, community-based cohort study. A total of 29.6% (n = 24) of participants received hospice care prior to death. Participants in hospice experienced less pain compared to those not in hospice, but this did not reach statistical significance (41.7% vs. 62.5%, P = 0.085). They were 65% more likely to be free of psychiatric symptoms (including restlessness, sleep problems, agitation, nervousness, and aggression toward others) during their final illness prior to death (OR = 0.35; 95% CI 0.13-0.96). In this cohort of people with dementia and MCI who died, several markers of quality of care suggest that hospice care can be beneficial for patients with dementia or MCI.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Bekelman
authors.forename: Betty S
authors.initials: BS
authors.lastname: Black
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Shore
authors.forename: Judy D
authors.initials: JD
authors.lastname: Kasper
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000523:psychology / Q000628:therapy*; D003657:Decision Making; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000523:psychology; D059408:Pain Management; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales