Palliative care for nursing home patients with dementia: Service evaluation and risk factors of mortality
Open accessAbstract
BACKGROUND: Difficulties in prognostication are common deterrents to palliative care among dementia patients. This study aimed to evaluate the effectiveness of palliative care in reducing the extent of utilization of medical services and the potential risk factors of mortality among dementia patients receiving palliative care. METHODS: We surveyed dementia patients involved in a palliative care program at a long-term care facility in Taipei, Taiwan. We enrolled 57 patients with advanced dementia (clinical dementia rating ≥ 5 or functional assessment staging test stage 7b). We then compared the extent of their utilization of medical services before and after the provision of palliative care. Based on multivariable logistic regression, we identified potential risk factors before and after the provision of palliative care associated with 6-month mortality. RESULTS: The utilization of medical services was significantly lower among dementia patients after the provision of palliative care than before, including visits to medical departments (p < 0.001), medications prescribed (p < 0.001), frequency of hospitalization (p < 0.001), and visits to the emergency room (p < 0.001). Moreover, patients dying within 6 months after the palliative care program had a slightly but not significantly higher number of admissions before receiving hospice care (p = 0.058) on univariate analysis. However, no significant differences were observed in multivariate analysis. CONCLUSIONS: The provision of palliative care to dementia patients reduces the extent of utilization of medical services. However, further studies with larger patient cohorts are required to stratify the potential risk factors of mortality in this patient group.
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Early and structured palliative care consultations played a critical role in aligning care with family goals, such as enabling people with dementia to remain at home until death.
“Early and structured palliative care consultations played a critical role in aligning care with family goals, such as enabling people with dementia to remain at home until death (Chu et al., 2020; Hanson et al., 2019).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Chu et al., 2020
The Methods (Data sources) describe family meetings to explain palliative care and obtain consent, and the Discussion (Characteristics of patients and service providers) describes regular consultations in nursing homes. But the Conclusions say the study could not determine the ideal timing for referral; the paper does not establish that early consultations aligned care with family goals or enabled patients to remain at home until death. Page numbers are not available in our copy. (LLM, conf=0.88)
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- Authors
- Chu, C.-P., Huang, C.-Y., Kuo, C.-J., Chen, Y.-Y., Chen, C.-T., Yang, T.-W., & Liu, H.-C.
- Affiliations
- Taipei City Hospital (TW)
- Taipei Medical University Hospital (TW)
- University of Taipei (TW)
- Corresponding author
- Liu, Hsing-Cheng
- Venue
- BMC Palliative Care
- Published
- 2020-08-12
- Volume
- 19
- Issue
- 1
- Pages
- 122-122
- ISSN
- 1472-684X (ISSN-L)
- PMC
- PMC7425598
- OpenAlex
- W3048698337
- Cited by
- 16
- References
- 38
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 1 · 2020: 1
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Palliative Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Science and Technology, Taiwan (MOST 108-2314-B-532-005)
- Taipei City Hospital (10501-62-015)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- palliative care, dementia, nursing home residents, long-term care, health care utilization, mortality risk factors, hospice care, hospitalization, emergency department visits, medication use, outcome prediction
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Hospitalization, Hospitals, Psychiatric, Humans, Male, Nursing Homes, Palliative Care, Risk Factors, Taiwan
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