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Last three days of life in the hospital: a comparison of symptoms, signs and treatments in the young old and the oldest old patients using the Resident Assessment Instrument for Palliative Care
Author(s) -
Steindal Simen A.,
Ranhoff Anette H.,
Bredal Inger S.,
Sørbye Liv W.,
Lerdal Anners
Publication year - 2013
Publication title -
international journal of older people nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.707
H-Index - 29
eISSN - 1748-3743
pISSN - 1748-3735
DOI - 10.1111/j.1748-3743.2012.00313.x
Subject(s) - medicine , delirium , palliative care , medical record , peripheral edema , pediatrics , intensive care medicine , adverse effect , nursing
Background. Knowledge concerning the provision of end of life care to the oldest old hospitalised patients is deficient. Aims and objectives. To analyse whether there were differences in registered nurses’ documentation of the young old vs. the oldest old patients according to symptoms, clinical signs and treatment in the last 3 days of life. Design. Data were collected retrospectively in a cross‐sectional comparative study at a hospital between autumn 2007 and spring 2009. Methods. The study included 190 patients: 101 (65–84 years) and 89 (85+). Data were extracted from the patients’ electronic records using the Resident Assessment Instrument for Palliative Care (RAI‐PC). Results. Falls (OR = 4.01, 95% CI 1.47–10.90) and peripheral oedema (OR = 2.74, 95% CI 1.06–7.11) were significantly more frequent documented in the oldest old patients compared with the young old patients. Delirium was recorded in 15.3% of all patients. Conclusion. With the exception of more falls and peripheral oedema in the oldest old patients, this study showed no differences in symptoms and treatment between the young old and the oldest old patients. Delirium was poorly documented compared to other studies. Implications for practice. The oldest old patients have a higher risk of falls in the final phase of life, and fall prevention should be considered.