title: Hospice referral after inpatient psychiatric treatment of individuals with advanced dementia from a nursing home.
abstract: This report addresses the discharge disposition following inpatient psychiatric treatment for advanced dementia. The total population included 685 305 Medicare fee-for-service decedents with advanced cognitive and functional impairment, with a mean age of 85.9 years who had resided in a nursing home. In the last 90 days of life, 1027 (0.15%) persons received inpatient psychiatry treatment just prior to the place of care where the individual died. Discharge dispositions included 132 (12.9%) persons to a medical hospital, 728 (70.9%) to nursing home without hospice services, 73 (7.1%) to hospice services in a nursing home, 32 (3.1%) to home without hospice services, and 16 (1.6%) to hospice services at home. Overall, the rate of referral to hospice services for advanced dementia was relatively low.
authors.affiliation: Brown University, Providence, RI, USA Butler Hospital, Providence, RI, USA gary_epstein-lubow@brown.edu.
authors.forename: Gary
authors.initials: G
authors.lastname: Epstein-Lubow
authors.affiliation: Brown University, Providence, RI, USA Butler Hospital, Providence, RI, USA.
authors.forename: Ana Tuya
authors.initials: AT
authors.lastname: Fulton
authors.affiliation: Brown University, Providence, RI, USA Butler Hospital, Providence, RI, USA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Marino
authors.affiliation: Brown University, Providence, RI, USA Rhode Island Hospital, Providence, RI, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Teno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000451:nursing*; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014481:United States
keywords: dementia; hospice; inpatient psychiatry hospitalization