title: Place of death for the 'oldest old': > or =85-year-olds in the CC75C population-based cohort.
abstract: BACKGROUND
  Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce.
  
  
  OBJECTIVE
  To examine the place of residence or care of > or =85 year-olds less than a year before death, and their place of death, and to map individual changes between the two.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Cambridge City over-75s Cohort (CC75C) study, UK.
  
  
  METHODS
  Retrospective analysis of prospective data from males and females aged > or =85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage.
  
  
  RESULTS
  Only 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes.
  
  
  CONCLUSIONS
  More than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old.
authors.affiliation: Institute of Public Health, University of Cambridge, Cambridge. jane.fleming@phpc.cam.ac.uk
authors.forename: Jane
authors.initials: J
authors.lastname: Fleming
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.forename: Morag
authors.initials: M
authors.lastname: Farquhar
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Stephen
authors.initials: S
authors.lastname: Barclay
mesh_terms: D017677:Age Distribution; D000369:Aged, 80 and over; D001293:Attitude to Death; D004739:England / Q000453:epidemiology; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013727:Terminal Care / Q000592:standards*