title: [Home end-of-life care for advanced dementia vs advanced cancer elderly patients: dying elderly at home project].
abstract: OBJECTIVE
  The aim of this study was to assess the frequency of symptoms and end-of-life care received in advanced dementia and advanced cancer elderly patients dying at home during the last two days of their lives and to evaluate the differences observed between the two groups.
  
  
  METHODS
  We used data from the Dying Elderly at Home (DEATH) project, which was a prospective study of home elderly patients dying with end-stage illness. Consecutive deceased subjects aged 65 or older who were seen at 16 study clinics belonging to the Japanese Society of Hospice and Home-care with diagnoses of all illnesses including advanced dementia and advanced cancer and died at home from October 2002 to September 2004 were included in the study. We evaluated 36 deceased subjects with advanced dementia and 116 with advanced cancer. We collected the following information: sociodemographics, ADLs, cognitive impairment, observed symptoms and end-of-life care provided during the last 48 hours of life.
  
  
  RESULTS
  Deceased subjects with advanced dementia were less likely to show symptoms of pain, acute confusion, or nausea/vomiting and more likely to display fever or cough than advanced cancer patients. Also, those with advanced dementia were more likely to receive intravenous drip injection or narcotic analgesia and more likely to be given sputum suction, or antibiotics.
  
  
  CONCLUSIONS
  We observed that the dying process and end-of-life care for advanced dementia elderly patients was different from that for advanced cancer elderly patients.
authors.affiliation: Department of Geriatrics, Nagoya University Graduate School of Medicine.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Masuda
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuzuya
authors.forename: Akihisa
authors.initials: A
authors.lastname: Iguchi
authors.forename: Takiko
authors.initials: T
authors.lastname: Asahi
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Uemura
mesh_terms: D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D003643:Death; D003704:Dementia / Q000451:nursing*; D005260:Female; D006699:Home Care Services; D017051:Hospice Care; D006801:Humans; D008297:Male; D009294:Narcotics / Q000627:therapeutic use; D009369:Neoplasms / Q000451:nursing*; D010146:Pain / Q000188:drug therapy; D011446:Prospective Studies
chemical_list: D009294:Narcotics