End-of-Life Care Needs and the Care Provided Before Death to Canadian Hospital Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/202272
Type:
Presentation
Title:
End-of-Life Care Needs and the Care Provided Before Death to Canadian Hospital Patients
Abstract:
(41st Biennial Convention) Although a shift of death out of hospital has taken place, 60% of all deaths in Canada still occur in hospital. The care needed and provided to dying persons in hospital is of considerable interest for ethical and other reasons. Many studies have found end-of-life care in hospital is often cure-oriented, but recent studies are showing palliative care has had a major impact. A Canadian study 14 years ago found only 4% of hospital decedents had received CPR, but with technologies (IV, oxygen, etc.) often used until death occurred. With population aging and healthcare advances meaning 90% of deaths now are not sudden or unexpected, the opportunity to direct care through advance directives and many other changes lead to a repeat study. This study involved a review of 1,018 charts of decedents in 1 recent year at 2 large Canadian hospitals. Only 8.8% had CPR provided immediately prior to death and 13.8% had CPR provided at some point, with age not a significant factor. Females most often needed total care. Having a cancer diagnosis and being <65 greatly increased the likelihood of dying in a Palliative Care Unit. Most died with one or more technologies in use (89% IV and 89% Oxygen). Only 7% had technologies withdrawn near the EOL. Patients with technologies withdrawn were often younger and from a rural area. Yet, 54.6% of deaths were expected and 45.4% not; 96.4% of expected deaths followed a DNR order, and 77% of unexpected deaths had a DNR order. In total, 13.9% did not have a DNR order. Finally, 30.8% had a written living will, while another 0.7% had a verbal living will and another 0.7% of families asked for no resuscitation. End-of-life care developments are occurring, and can be expected as annual deaths double over the current 250,000 per year.
Keywords:
dying care needs; palliative and end of life care; hospital services
Repository Posting Date:
11-Jan-2012
Date of Publication:
4-Jan-2012
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEnd-of-Life Care Needs and the Care Provided Before Death to Canadian Hospital Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/202272-
dc.description.abstract(41st Biennial Convention) Although a shift of death out of hospital has taken place, 60% of all deaths in Canada still occur in hospital. The care needed and provided to dying persons in hospital is of considerable interest for ethical and other reasons. Many studies have found end-of-life care in hospital is often cure-oriented, but recent studies are showing palliative care has had a major impact. A Canadian study 14 years ago found only 4% of hospital decedents had received CPR, but with technologies (IV, oxygen, etc.) often used until death occurred. With population aging and healthcare advances meaning 90% of deaths now are not sudden or unexpected, the opportunity to direct care through advance directives and many other changes lead to a repeat study. This study involved a review of 1,018 charts of decedents in 1 recent year at 2 large Canadian hospitals. Only 8.8% had CPR provided immediately prior to death and 13.8% had CPR provided at some point, with age not a significant factor. Females most often needed total care. Having a cancer diagnosis and being <65 greatly increased the likelihood of dying in a Palliative Care Unit. Most died with one or more technologies in use (89% IV and 89% Oxygen). Only 7% had technologies withdrawn near the EOL. Patients with technologies withdrawn were often younger and from a rural area. Yet, 54.6% of deaths were expected and 45.4% not; 96.4% of expected deaths followed a DNR order, and 77% of unexpected deaths had a DNR order. In total, 13.9% did not have a DNR order. Finally, 30.8% had a written living will, while another 0.7% had a verbal living will and another 0.7% of families asked for no resuscitation. End-of-life care developments are occurring, and can be expected as annual deaths double over the current 250,000 per year.en_GB
dc.subjectdying care needsen_GB
dc.subjectpalliative and end of life careen_GB
dc.subjecthospital servicesen_GB
dc.date.available2012-01-11T11:19:25Z-
dc.date.issued2012-01-04en_GB
dc.date.accessioned2012-01-11T11:19:25Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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