[Journal article] Factors Associated with the Place of Death of Persons with Advanced Dementia: A Systematic Review of International Literature with Meta-Analysis
06 Aug 2024
Authors: RiYin Tay, Joyce YS Tan, Bin Yan Lim, Allyn YM Hum, Jane Simpson, Nancy Preston
Published in: Palliative Medicine. 2024. doi:10.1177/02692163241265231
Summary points:
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Despite preferences, dying at the usual place of residence such as home for people with advanced dementia is particularly challenging, with many of them dying in hospital.
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The synthesis of 33 relevant papers in this review found that being married was associated with home death, while being younger and male, having pneumonia and COPD were associated with hospital death, which was less likely with co-morbid cancer, functional impairment and a capitated funding model; however, unlike advanced cancer, hospital/nursing home bed availability had no effect on the place of death in advanced dementia.
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These results highlight the profound challenges of advanced dementia end-of-life care due to its protracted, unpredictable nature – to meet the specific needs and preferences of the increasing number of people with advanced dementia and their families appropriately while ensuring sustainability, integrating palliative care into the healthcare system, funded by a mechanism that incentivises care coordination such as capitation, is recommended.