Research Article
End-of-Life Care for Aged Care Residents Presenting to Emergency Departments
Jo-Anne Wilkinson1*, Maryann Street2,3, Sonia Fullerton1 and Patricia M Livingston2,3
1Eastern Health251 Mountain Highway, Wantirna 3152, Australia
2Faculty of Health, Deakin University, 221 Burwood Highway, Burwood Victoria 3125, Australia
3Eastern Health, 251 Mountain Highway, Wantirna 3152, Australia
4Faculty of Health, Deakin University, 221 Burwood Highway, Burwood Victoria 3125, Australia
- *Corresponding Author:
- Jo-Anne Wilkinson
RN, Grad Dip Nat, Eastern Health, 251 Mountain Highway
Wantirna 3152, Australia
Tel: 040061894
Fax: 613-9955- 1384
E-mail: Jo-anne.wilkinson@easternhealth.org.au
Received date March 27, 2012; Accepted date June 21, 2012; Published date June 25, 2012
Citation: Wilkinson JA, Maryann, Fullerton S, Livingston PM (2012) End-of-Life Care for Aged Care Residents Presenting to Emergency Departments. J Palliative Care Med 2:121. doi:10.4172/2165-7386.1000121
Copyright: © 2012 Wilkinson JA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: The number of patients from Aged Care presenting to acute care is increasing, many of whom have a life limiting illness.
Aims: To identify differences in relation to Aged Care Residents presenting to Emergency departments who died during a hospital admission compared to those who were referred to the hospital based palliative care. Methods: Review of a stratified random sample of 90 Aged Care residents transferred to acute care who died during admission in 2009; half the sample received palliative care. Comparisons were made with regard to age; gender; co-morbidities; symptoms, investigations and active treatment; prior admissions and costs. Results: The median age of patients was 87.5 years, 61% were female and 38% had three or more admissions in the year prior to death. Patients with a length of stay of four or more days were 2.98 times (CI, 95%:1.11-8.03) and patients with agitation were 3.08 (CI 95%:1.10- 8.64) times more likely to be referred to palliative care. Patients who received palliative care had significantly fewer investigations or active treatment in the 24 hours prior to their death (p< 0.01) and palliated patients had significantly lower average costs per day of admission ($1022, SD=$441) compared to those who were not palliated ($ 831; SD= $ 1041) (p< 0.001). Discussion: Our study indicates there is a difference between dying patients who received palliative care compared to those who did not in an acute care setting. Further research into the outcomes of patients discharged back to Aged Care facilities for palliative care warrants investigation.