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Abstract
BackgroundLittle is known about the type of care older people of different ages receive at the end of life. The goal of treatment is an important parameter of the quality of end-of-life care. This study aims to provide an evaluation of the main goal of treatment in the last week of life of people aged 86 and older compared with those between 75 and 85 and to examine how treatment goals are associated with age.MethodsPopulation- based cross sectional survey in Flanders, Belgium. A stratified random sample of death certificates was drawn of people who died between 1 June and 30 November 2007. The effective study sample included 3,623 deaths (response rate: 58.4%). Non-sudden deaths of patients aged 75 years and older were selected (N = 1681). Main outcome was the main goal of treatment in the last week of life (palliative care or life-prolonging/curative treatment).ResultsIn patients older than 75, the main goal of treatment in the last week was in the majority of cases palliative care (77.9%). Patients between 75 and 85 more often received life-prolonging/curative treatment than older patients (26.6% vs. 15.8%). Most patient and health care characteristics are similarly related to the main goal of treatment in both age groups. The patient’s age was independently related to having comfort care as the main goal of treatment. The main goal of treatment was also independently associated with the patient’s sex, cause and place of death and the time already in treatment.ConclusionAge is independently related to the main goal of treatment in the last week of life with people over 85 being more likely to receive palliative care and less likely to receive curative/life-prolonging treatment compared with those aged 75–85. This difference could be due to the patient’s wishes but could also be the result of the attitudes of care givers towards the treatment of older people.
Highlights
Little is known about the type of care that older people of different ages receive at the end of life
Palliative care is aimed at improving the quality of life of patients and their families by providing relief from physical, psychological and spiritual problems, while curative treatment is focused on cure or management of a chronic disease and on prolonging life [2,3,4]
Studies have shown that the quality of end-of-life care for older people is often suboptimal, especially in hospitals where burdensome interventions aimed at cure or prolonging life are sometimes continued until death [8,9,10]
Summary
Little is known about the type of care older people of different ages receive at the end of life. Little is known about the type of care that older people of different ages receive at the end of life. Palliative care is aimed at improving the quality of life of patients and their families by providing relief from physical, psychological and spiritual problems, while curative treatment is focused on cure or management of a chronic disease and on prolonging life [2,3,4]. Studies have shown that the quality of end-of-life care for older people is often suboptimal, especially in hospitals where burdensome interventions aimed at cure or prolonging life are sometimes continued until death [8,9,10]. A growing body of scientific literature shows that provision of end-of-life care varies between patients of different ages [11,12,13]
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