Care dependency of patients and residents at the end of life: A secondary data analysis of data from a cross-sectional study in hospitals and geriatric institutions.
Gerhilde Schüttengruber, Ruud J G Halfens, Christa Lohrmann
PMID 34151486WHAT IT FOUND
End-of-life patients and residents were highly care dependent: 60% were completely or greatly dependent, versus 12% of non-end-of-life patients.
Dementia and older age predicted high dependency across all assessment items.
Key findings
01Among patients and residents identified as end of life, 60% were completely or to a great extent care dependent, while 12% of those not identified as end of life were completely or to a great extent care dependent.
02Age and dementia significantly predicted likelihood of being highly care dependent for every item of the Care Dependency Scale.
03End-of-life patients with dementia (n=168) were significantly more care dependent across all items than end-of-life patients without dementia (n=221).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
End-of-life status was assigned subjectively by the interdisciplinary team, not by an objective diagnosis or prognosis. Data were collected on one day only, so the study cannot show when dependency started or that dependency caused end-of-life recognition. The end-of-life sample was 389, which the authors call small. Nurses completed the Care Dependency Scale by consensus rather than using patient-reported ratings, so ratings may reflect staff judgement. The paper reports associations from logistic regression, not tested effects of nursing care.
Declared interests
The author declared no conflicts of interest. Funding details are not stated.
The easy way to misread this
Do not conclude that rising care dependency proves a patient is entering the end-of-life phase. The end-of-life group was defined by subjective interdisciplinary judgement, and this one-day observational study can only show association, not cause.