End-of-life care in assisted living and related residential care settings: Comparison with nursing homes
End-of-life care in assisted living and related residential care settings: Comparison with nursing homes
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DOI：
10.1046/j.1532-5415.2003.51511.x
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发表时间：
2003-11-01
影响因子：
6.3
通讯作者：
Custis-Buie, V
中科院分区：
文献类型：
--
作者：
Sloane, PD;Zimmerman, S;Custis-Buie, V
目的：设计：对一项纵向研究中发生的死亡事件的工作人员和家庭知情人的访谈。设置：55个RC/AL设施和26个NHs，分别位于佛罗里达、马里兰州、新泽西和北卡罗来纳州。参与者：224名最了解73名RC/AL居民和72名NH居民的工作人员和家庭知情人在研究机构出院后3天内死亡。对最了解死者的机构工作人员和在生命最后一个月最常参与护理的家庭成员进行电话访谈死者的。数据收集的情况下死亡，死亡过程中的看法，死亡原因，照顾在最后一个月的生活，情绪，不适，和家庭satisfactions.RESULTS：大多数死者死亡的设施，他们居住的，超过一半的科目是独自一人时，他们死了。NHS的大部分工作人员和家人都知道，居民的死亡只有几天或几周的时间。RC/AL和NH居民经历了一些高度负面的情绪，即使在他们最不舒服的一天，整体不适是低的居民在这两种设施类型。RC/AL组的家庭满意度总评分（32.1）显著高于NH组（41.2）（P= 0.016）。结论：这些数据表明，RC/AL环境中的临终关怀在过程和结果方面与NH相似。因此，在RC/AL中可以有效地发生老化和原位死亡。
OBJECTIVES: To define the current state of end-of-life care in residential care/assisted living (RC/AL) facilities and nursing homes (NHs) and to compare these two types of care settings.DESIGN: Interviews of staff and family informants about deaths that occurred during a longitudinal study.SETTING: Fifty-five RC/AL facilities and 26 NHs in Florida, Maryland, New Jersey, and North Carolina.PARTICIPANTS: Two hundred twenty-four staff and family informants that best knew the 73 RC/AL residents and 72 NH residents who died in or within 3 days after discharge from a study facility.MEASUREMENTS: Telephone interviews conducted with the facility staff member who knew the decedent best and the family member who was most involved in care during the last month of life of the decedent. Data were collected on circumstances of death, perceptions of dying process, cause of death, care during the last month of life, mood, discomfort, and family satisfaction.RESULTS: Most decedents died in the facility where they had resided, and more than half of the subjects were alone when they died. Greater proportions of staff and family in the NHs knew that the resident's death was only days or weeks away. Both RC/AL and NH residents experienced few highly negative moods, and even on their most uncom-fortable day, the overall discomfort was low for residents in both facility types. Summary ratings of family satisfaction were significantly higher for the RC/AL (32.1) than the NH (41.2) group (P=.016).CONCLUSION: These data suggest that end-of-life care in RC/AL settings appears similar in process and outcomes to that provided in NHs. Thus, aging and dying-in-place can effectively occur in RC/AL.