Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes
To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment. Cohort longitudinal study. Residential care homes for the elderly in Hong Kong West. Residents of such homes age...
Gespeichert in:
| Veröffentlicht in: | Hong Kong medical journal = Xianggang yi xue za zhi 2013-12, Vol.19 (6), p.518-524 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 524 |
|---|---|
| container_issue | 6 |
| container_start_page | 518 |
| container_title | Hong Kong medical journal = Xianggang yi xue za zhi |
| container_volume | 19 |
| creator | Luk, James K H Chan, W K Ng, W C Chiu, Patrick K C Ho, Celina Chan, T C Chan, Felix H W |
| description | To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment.
Cohort longitudinal study.
Residential care homes for the elderly in Hong Kong West.
Residents of such homes aged 65 years or more with advanced cognitive impairment.
In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P |
| doi_str_mv | 10.12809/hkmj133951 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1465863861</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2786943373</sourcerecordid><originalsourceid>FETCH-LOGICAL-c354t-b3e1216aa72b8daba2abfabbfcfeaa6e46437e84e39a41e7c70b4a8fee1d8a7c3</originalsourceid><addsrcrecordid>eNpd0c9rFTEQB_Agin2tnrxLwEuhrM2vl2SPUqotVLzY8zKbne3LM5usSfZJb_7pLrZW6Glg-MyXgS8h7zj7yIVl7fnux7TnUrZb_oJshBC6sYaZl2TDmVCNMMwekeNS9owJu23Za3IkFGu11GxDfn9NuULw9Z5CHOgOIdQdLZgP3mGhS_XBF6g-RQpTinc0hQEznTHNAekvv2IYDhAdDtSlu-irPyD10ww-TxgrDf7g1zMfacbih3XlIVAHGekuTVjekFcjhIJvH-cJuf18-f3iqrn59uX64tNN4-RW1aaXyAXXAEb0doAeBPQj9P3oRgTQqLSSBq1C2YLiaJxhvQI7IvLBgnHyhJw-5M45_Vyw1G7yxWEIEDEtpeNKb62WVvOVfnhG92nJcf2uE8bqVklp5KrOHpTLqZSMYzdnP0G-7zjr_hbT_S9m1e8fM5d-wuHJ_mtC_gFNK41U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2786943373</pqid></control><display><type>article</type><title>Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Luk, James K H ; Chan, W K ; Ng, W C ; Chiu, Patrick K C ; Ho, Celina ; Chan, T C ; Chan, Felix H W</creator><creatorcontrib>Luk, James K H ; Chan, W K ; Ng, W C ; Chiu, Patrick K C ; Ho, Celina ; Chan, T C ; Chan, Felix H W ; Department of Medicine and Geriatrics, Fung Yiu King Hospital, 9 Sandy Bay Road, Pokfulam, Hong Kong</creatorcontrib><description>To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment.
Cohort longitudinal study.
Residential care homes for the elderly in Hong Kong West.
Residents of such homes aged 65 years or more with advanced cognitive impairment.
In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P<0.001), and utilised more services from community care nurses for wound care (P=0.001), enteral feeding tube care (P=0.018), and urinary catheter care (P<0.001). Independent risk factors for 1-year mortality were active pressure sores (P=0.0037), enteral feeding (P=0.008), having a urinary catheter (P=0.0036), and suffering from chronic obstructive pulmonary disease (P=0.011). A history of pneumococcal vaccination was protective with respect to 1-year mortality (P=0.004).
Residents of residential care homes for the elderly with advanced cognitive impairment were frail, exhibited multiple co-morbidities and high mortality. They were frequent users of out-patient, emergency, and in-patient services. The development of end-of-life care services in residential care homes for the elderly is an important need for this group of elderly.</description><identifier>ISSN: 1024-2708</identifier><identifier>EISSN: 2226-8707</identifier><identifier>DOI: 10.12809/hkmj133951</identifier><identifier>PMID: 24096360</identifier><language>eng</language><publisher>China: Hong Kong Academy of Medicine</publisher><subject>Aged ; Aged, 80 and over ; Cognition Disorders - mortality ; Cognition Disorders - physiopathology ; Cognition Disorders - therapy ; Cognitive ability ; Cohort Studies ; Comorbidity ; Enteral Nutrition - statistics & numerical data ; Female ; Frail Elderly ; Health Services Needs and Demand ; Health services utilization ; Homes for the Aged - statistics & numerical data ; Hong Kong ; Humans ; Longitudinal Studies ; Male ; Mortality ; Nursing Homes - statistics & numerical data ; Older people ; Risk Factors ; Terminal Care - organization & administration</subject><ispartof>Hong Kong medical journal = Xianggang yi xue za zhi, 2013-12, Vol.19 (6), p.518-524</ispartof><rights>2013. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at https://www.hkmj.org/about/website.html</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-b3e1216aa72b8daba2abfabbfcfeaa6e46437e84e39a41e7c70b4a8fee1d8a7c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24096360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luk, James K H</creatorcontrib><creatorcontrib>Chan, W K</creatorcontrib><creatorcontrib>Ng, W C</creatorcontrib><creatorcontrib>Chiu, Patrick K C</creatorcontrib><creatorcontrib>Ho, Celina</creatorcontrib><creatorcontrib>Chan, T C</creatorcontrib><creatorcontrib>Chan, Felix H W</creatorcontrib><creatorcontrib>Department of Medicine and Geriatrics, Fung Yiu King Hospital, 9 Sandy Bay Road, Pokfulam, Hong Kong</creatorcontrib><title>Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes</title><title>Hong Kong medical journal = Xianggang yi xue za zhi</title><addtitle>Hong Kong Med J</addtitle><description>To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment.
Cohort longitudinal study.
Residential care homes for the elderly in Hong Kong West.
Residents of such homes aged 65 years or more with advanced cognitive impairment.
In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P<0.001), and utilised more services from community care nurses for wound care (P=0.001), enteral feeding tube care (P=0.018), and urinary catheter care (P<0.001). Independent risk factors for 1-year mortality were active pressure sores (P=0.0037), enteral feeding (P=0.008), having a urinary catheter (P=0.0036), and suffering from chronic obstructive pulmonary disease (P=0.011). A history of pneumococcal vaccination was protective with respect to 1-year mortality (P=0.004).
Residents of residential care homes for the elderly with advanced cognitive impairment were frail, exhibited multiple co-morbidities and high mortality. They were frequent users of out-patient, emergency, and in-patient services. The development of end-of-life care services in residential care homes for the elderly is an important need for this group of elderly.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cognition Disorders - mortality</subject><subject>Cognition Disorders - physiopathology</subject><subject>Cognition Disorders - therapy</subject><subject>Cognitive ability</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Enteral Nutrition - statistics & numerical data</subject><subject>Female</subject><subject>Frail Elderly</subject><subject>Health Services Needs and Demand</subject><subject>Health services utilization</subject><subject>Homes for the Aged - statistics & numerical data</subject><subject>Hong Kong</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Mortality</subject><subject>Nursing Homes - statistics & numerical data</subject><subject>Older people</subject><subject>Risk Factors</subject><subject>Terminal Care - organization & administration</subject><issn>1024-2708</issn><issn>2226-8707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpd0c9rFTEQB_Agin2tnrxLwEuhrM2vl2SPUqotVLzY8zKbne3LM5usSfZJb_7pLrZW6Glg-MyXgS8h7zj7yIVl7fnux7TnUrZb_oJshBC6sYaZl2TDmVCNMMwekeNS9owJu23Za3IkFGu11GxDfn9NuULw9Z5CHOgOIdQdLZgP3mGhS_XBF6g-RQpTinc0hQEznTHNAekvv2IYDhAdDtSlu-irPyD10ww-TxgrDf7g1zMfacbih3XlIVAHGekuTVjekFcjhIJvH-cJuf18-f3iqrn59uX64tNN4-RW1aaXyAXXAEb0doAeBPQj9P3oRgTQqLSSBq1C2YLiaJxhvQI7IvLBgnHyhJw-5M45_Vyw1G7yxWEIEDEtpeNKb62WVvOVfnhG92nJcf2uE8bqVklp5KrOHpTLqZSMYzdnP0G-7zjr_hbT_S9m1e8fM5d-wuHJ_mtC_gFNK41U</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Luk, James K H</creator><creator>Chan, W K</creator><creator>Ng, W C</creator><creator>Chiu, Patrick K C</creator><creator>Ho, Celina</creator><creator>Chan, T C</creator><creator>Chan, Felix H W</creator><general>Hong Kong Academy of Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BVBZV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes</title><author>Luk, James K H ; Chan, W K ; Ng, W C ; Chiu, Patrick K C ; Ho, Celina ; Chan, T C ; Chan, Felix H W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-b3e1216aa72b8daba2abfabbfcfeaa6e46437e84e39a41e7c70b4a8fee1d8a7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cognition Disorders - mortality</topic><topic>Cognition Disorders - physiopathology</topic><topic>Cognition Disorders - therapy</topic><topic>Cognitive ability</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Enteral Nutrition - statistics & numerical data</topic><topic>Female</topic><topic>Frail Elderly</topic><topic>Health Services Needs and Demand</topic><topic>Health services utilization</topic><topic>Homes for the Aged - statistics & numerical data</topic><topic>Hong Kong</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Mortality</topic><topic>Nursing Homes - statistics & numerical data</topic><topic>Older people</topic><topic>Risk Factors</topic><topic>Terminal Care - organization & administration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luk, James K H</creatorcontrib><creatorcontrib>Chan, W K</creatorcontrib><creatorcontrib>Ng, W C</creatorcontrib><creatorcontrib>Chiu, Patrick K C</creatorcontrib><creatorcontrib>Ho, Celina</creatorcontrib><creatorcontrib>Chan, T C</creatorcontrib><creatorcontrib>Chan, Felix H W</creatorcontrib><creatorcontrib>Department of Medicine and Geriatrics, Fung Yiu King Hospital, 9 Sandy Bay Road, Pokfulam, Hong Kong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>East & South Asia Database</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Hong Kong medical journal = Xianggang yi xue za zhi</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luk, James K H</au><au>Chan, W K</au><au>Ng, W C</au><au>Chiu, Patrick K C</au><au>Ho, Celina</au><au>Chan, T C</au><au>Chan, Felix H W</au><aucorp>Department of Medicine and Geriatrics, Fung Yiu King Hospital, 9 Sandy Bay Road, Pokfulam, Hong Kong</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes</atitle><jtitle>Hong Kong medical journal = Xianggang yi xue za zhi</jtitle><addtitle>Hong Kong Med J</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>19</volume><issue>6</issue><spage>518</spage><epage>524</epage><pages>518-524</pages><issn>1024-2708</issn><eissn>2226-8707</eissn><abstract>To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment.
Cohort longitudinal study.
Residential care homes for the elderly in Hong Kong West.
Residents of such homes aged 65 years or more with advanced cognitive impairment.
In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P<0.001), and utilised more services from community care nurses for wound care (P=0.001), enteral feeding tube care (P=0.018), and urinary catheter care (P<0.001). Independent risk factors for 1-year mortality were active pressure sores (P=0.0037), enteral feeding (P=0.008), having a urinary catheter (P=0.0036), and suffering from chronic obstructive pulmonary disease (P=0.011). A history of pneumococcal vaccination was protective with respect to 1-year mortality (P=0.004).
Residents of residential care homes for the elderly with advanced cognitive impairment were frail, exhibited multiple co-morbidities and high mortality. They were frequent users of out-patient, emergency, and in-patient services. The development of end-of-life care services in residential care homes for the elderly is an important need for this group of elderly.</abstract><cop>China</cop><pub>Hong Kong Academy of Medicine</pub><pmid>24096360</pmid><doi>10.12809/hkmj133951</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1024-2708 |
| ispartof | Hong Kong medical journal = Xianggang yi xue za zhi, 2013-12, Vol.19 (6), p.518-524 |
| issn | 1024-2708 2226-8707 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1465863861 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Aged, 80 and over Cognition Disorders - mortality Cognition Disorders - physiopathology Cognition Disorders - therapy Cognitive ability Cohort Studies Comorbidity Enteral Nutrition - statistics & numerical data Female Frail Elderly Health Services Needs and Demand Health services utilization Homes for the Aged - statistics & numerical data Hong Kong Humans Longitudinal Studies Male Mortality Nursing Homes - statistics & numerical data Older people Risk Factors Terminal Care - organization & administration |
| title | Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T18%3A05%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mortality%20and%20health%20services%20utilisation%20among%20older%20people%20with%20advanced%20cognitive%20impairment%20living%20in%20residential%20care%20homes&rft.jtitle=Hong%20Kong%20medical%20journal%20=%20Xianggang%20yi%20xue%20za%20zhi&rft.au=Luk,%20James%20K%20H&rft.aucorp=Department%20of%20Medicine%20and%20Geriatrics,%20Fung%20Yiu%20King%20Hospital,%209%20Sandy%20Bay%20Road,%20Pokfulam,%20Hong%20Kong&rft.date=2013-12-01&rft.volume=19&rft.issue=6&rft.spage=518&rft.epage=524&rft.pages=518-524&rft.issn=1024-2708&rft.eissn=2226-8707&rft_id=info:doi/10.12809/hkmj133951&rft_dat=%3Cproquest_cross%3E2786943373%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2786943373&rft_id=info:pmid/24096360&rfr_iscdi=true |