Comparison of medical treatments for the dying in a hospice and a geriatric hospital in Japan.
BACKGROUND
Most older adults who die in Japan do so in the hospital without receiving hospice or palliative care. While there are some hospices in Japan, little is known about the care they provide to the elderly.


OBJECTIVE
To clarify how the care of dying patients differs in a hospice and a geriatric hospital in Japan.


METHODS
Cohort study.


METHODS
A hospice and a geriatric hospital in Japan.


METHODS
One hundred ninety-one inpatients aged 65 or older.


RESULTS
Areas of our interest: (1) gender and age; (2) primary disease(s) and cause of death; (3) observed symptoms/conditions and medical treatment or care conducted within 48 hours prior to death; (4) the actual topics leading to disclosure; and (5) whether or not advance directives had been given.


RESULTS
The X2 test determined that there were statistically significant differences between a geriatric hospital and a hospice, with respect to mean age, diagnoses on admission, primary cause of death, symptoms/conditions, and the practice of medical interventions. However, controlling for patient characteristics and assuming a bivariate distribution between the probabilities of choosing a facility and of undergoing a medical procedure, we found that patients at the hospice were more likely to undergo treatment with opioids, urethral catheter, and oral medicine; such patients were less likely to undergo oxygen inhalation, total parenteral nutrition, and other intravenous drips.


CONCLUSIONS
The hospice examined in this study was similar to the approach regarding medical treatments observed at the geriatric hospital.
Masuda
Yuichiro
Y
Department of Geriatrics, Graduate School of Medicine, Nagoya University, Japan. masuda@med.nagoya-u.ac.jp
Noguchi
Haruko
H
Kuzuya
Masafumi
M
Inoue
Akira
A
Hirakawa
Yoshihisa
Y
Iguchi
Akihisa
A
Uemura
Kazumasa
K
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D017051:Hospice Care / Q000458:organization & administration*; D006782:Hospitals, Special / Q000458:organization & administration*; D006801:Humans; D007564:Japan; D008297:Male; D012044:Regression Analysis; D013727:Terminal Care / Q000458:organization & administration*; D019452:Terminally Ill