Quality of End-of-Life Care for Older Adults with Dementia during the COVID-19 Pandemic.
Miharu Nakanishi, Asao Ogawa, Mai Sakai and 3 others
PMID 37030321WHAT IT FOUND
Deaths during the pandemic were rated as less excellent care than before.
People with dementia had more unmet spiritual needs. The pandemic did not worsen care specifically for dementia patients beyond this general decline.
Key findings
01Decedents who died during the pandemic were more likely to have an overall rating of care as being not excellent compared to those who died before the pandemic.
02Individuals with dementia were more likely to have unmet religious needs, specifically not talking about religion, than those without dementia.
03There was no interaction effect between dementia status and the pandemic period for any quality indicator, meaning the pandemic's negative impact on care quality was similar regardless of dementia status.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not specify the leading cause of death, including whether deaths were due to COVID-19. Dementia status and hospice engagement were not verified using Medicare claims data. Quality ratings relied on proxy perceptions, which may be biased by the proxy's awareness of the patient's dementia status or the pandemic context. Multiple regression analyses for 14 outcomes increased the risk of Type I error. Sampling weights were not applied, limiting the generalizability of the estimates to the broader US population.
Declared interests
The study was supported by the National Institute on Aging (grant number U01AG32947). No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not conclude that the pandemic disproportionately worsened care for patients with dementia. The study found no significant interaction between dementia status and the pandemic period, meaning the general decline in care quality affected patients with and without dementia similarly.