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10.1016/j.jpainsymman.2020.07.020

http://scihub22266oqcxt.onion/10.1016/j.jpainsymman.2020.07.020
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32721500!7382350!32721500
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suck abstract from ncbi


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pmid32721500      J+Pain+Symptom+Manage 2020 ; 60 (4): e2-e13
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  • Dying From COVID-19: Loneliness, End-of-Life Discussions, and Support for Patients and Their Families in Nursing Homes and Hospitals A National Register Study #MMPMID32721500
  • Strang P; Bergstrom J; Martinsson L; Lundstrom S
  • J Pain Symptom Manage 2020[Oct]; 60 (4): e2-e13 PMID32721500show ga
  • CONTEXT: Preparation for an impending death through end-of-life (EOL) discussions and human presence when a person is dying is important for both patients and families. OBJECTIVES: The aim was to study whether EOL discussions were offered and to what degree patients were alone at time of death when dying from coronavirus disease 2019 (COVID-19), comparing deaths in nursing homes and hospitals. METHODS: The national Swedish Register of Palliative Care was used. All expected deaths from COVID-19 in nursing homes and hospitals were compared with, and contrasted to, deaths in a reference population (deaths in 2019). RESULTS: A total of 1346 expected COVID-19 deaths in nursing homes (n = 908) and hospitals (n = 438) were analyzed. Those who died were of a more advanced age in nursing homes (mean 86.4 years) and of a lower age in hospitals (mean 80.7 years) (P < 0.0001). Fewer EOL discussions with patients were held compared with deaths in 2019 (74% vs. 79%, P < 0.001), and dying with someone present was much more uncommon (59% vs. 83%, P < 0.0001). In comparisons between nursing homes and hospital deaths, more patients dying in nursing homes were women (56% vs. 37%, P < 0.0001), and significantly fewer had a retained ability to express their will during the last week of life (54% vs. 89%, P < 0.0001). Relatives were present at time of death in only 13% and 24% of the cases in nursing homes and hospitals, respectively (P < 0.001). The corresponding figures for staff were 52% and 38% (P < 0.0001). CONCLUSION: Dying from COVID-19 negatively affects the possibility of holding an EOL discussion and the chances of dying with someone present. This has considerable social and existential consequences for both patients and families.
  • |*Betacoronavirus[MESH]
  • |*Loneliness[MESH]
  • |*Palliative Care[MESH]
  • |*Quality of Health Care[MESH]
  • |*Terminal Care[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |COVID-19[MESH]
  • |Child[MESH]
  • |Child, Preschool[MESH]
  • |Communication[MESH]
  • |Coronavirus Infections/mortality/*psychology/therapy[MESH]
  • |Female[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Infant[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Nursing Homes[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/mortality/*psychology/therapy[MESH]
  • |Registries[MESH]
  • |SARS-CoV-2[MESH]
  • |Social Support[MESH]
  • |Sweden/epidemiology[MESH]


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