Nursing homes send too many dementia residents to the hospital in their last year of life, study finds

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Nursing homes could do a better job of keeping residents with dementia out of the hospital during their last year of life, suggests recently published findings in Health Affairs.

About two-thirds of nursing home residents with dementia had at least one potentially avoidable hospitalization in their last year of life, the researchers determined. This is despite the fact that nursing homes, doctors and family members “are inclined to provide less aggressive end-of-life care to residents who have dementia,” they noted.

Seniors with dementia living in the community were even more likely to have a hospitalization in the last year of life, according to the study.

The findings reinforce the need for advance care planning for those with dementia “long before death,” the authors concluded.

The investigators, with RTI International, considered data collected between 2000 and 2008 by the Health and Retirement Study, which is a national survey conducted every two years. They linked the HRS information of roughly 12,400 people to Medicare claims, in order to track hospitalization rates for those with dementia.

Prior to the last year of life, a dementia diagnosis does not increase the likelihood of hospital use for nursing home residents. This is likely because long-term care providers have expertise in dementia care, the researchers noted. The presence of dementia does increase the likelihood of hospitalization for people living in a community setting. 

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