Research News: Emergency admissions to hospital for people with dementia are common and increasing
23rd August 2017
New research supported by Cicely Saunders International published 22 August 2017 has found that Accident and Emergency attendance for people with dementia is common and increasing.
For people who are approaching the end of life, attending A&E can be distressing. It is also often unnecessary and can be prevented. In recent years, there has been a drop in the number of people with dementia dying in hospital, seen as demonstrating better end of life care. But over three quarters of people with dementia were seen in A&E in their last year of life. This has also been increasing over time.
Sometimes people with dementia do need to be admitted to hospital, but admissions can also lead to deterioration, with an increased risk of infections, bedsores and distress.
In the study, the researchers identified people who had dementia and who had died over a five year period (2008 – 2013).
Out of 4,867 people with dementia who had died, 78.6% had at least one A&E attendance during their last year of life.
These findings are similar to those from the USA and Australia, where 81% and 73% of people with dementia had an A&E attendance in their last year of life.
A&E attendance became more common the closer people were to death, with just under half (44.5%) having an A&E attendance in their last month of life, and a fifth of people with dementia attending A&E in their last week of life.
People living in a care home had fewer A&E attendances, which may be because plans were put in place to avoid this.
The likelihood of attending A&E increased over time: people who died in the most recent year studied were 1.6 times more likely to attend A&E then in the previous years.
Lead author, Dr Katherine Sleeman from the Cicely Saunders Institute said: “Recognition of the need to improve end of life for people with dementia has been increasing. This includes enabling them to be cared for in their home or a care home. However, our results show a worrying increase in the reliance on emergency care. In light of the current pressures on the health service, our ageing population and the associated increase in deaths from dementia, there is an urgent need to look at ways we can provide better support for care in the community.”
Read the full paper here http://bit.ly/2vZyyb6
Sleeman KE, Perera G, Stewart R, Higginson IJ. Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data. Alzheimer’s & Dementia (2017) 1-8. DOI: 10.1016/j.jalz.2017.06.2267