Abstract
Aim: Associations between markedly low activities of daily living (ADL) at the start of home visit care and patient home death were analyzed using data from a home care support clinic Japan that has a low rate of home deaths. Methods: The study was a historical cohort study. It involved patients who began to receive home visit care from a home visit care support clinic between 1 April 2006 and 31 March 2011. Using home death as a dependent variable and presence/absence of markedly low ADL and other parameters (cancer, the patient's desire for home death, etc.) as independent variables, the adjusted hazard ratio and 95% confidence interval (CI) were calculated using the Cox proportional hazards model. Results: Markedly low ADL were associated with home death even after adjustment for factors that influence home death (adjusted hazard ratio 4.40; 95% CI 2.37-8.16). Cancer and the patient's desire for home death were statistically significant factors involved home death. a subgroup analysis according to the presence/absence of cancer, the association between markedly low ADL and home death was stronger the cancer-free group (adjusted hazard ratio 10.78; 95% CI 2.89-40.26) than the cancer group (adjusted hazard ratio 5.58; 95% CI2.39-13.05). Conclusion: Patients' desire for home death could be fulfilled if home care support clinics provide home visit services to not only terminal-stage cancer patients, but also bedridden cancer-free patients. We must establish systems for older adults to remaat home during the terminal period of their lives. Geriatr Gerontol Int 2012; 13: 874-880.
Original language | English |
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Pages (from-to) | 874-880 |
Number of pages | 7 |
Journal | Geriatrics and Gerontology International |
Volume | 13 |
Issue number | 4 |
DOIs | |
Publication status | Published - Oct 2013 |
Keywords
- Activities of daily living
- Cox proportional hazards model
- Home death
- Home visit
- Japan
ASJC Scopus subject areas
- Health(social science)
- Gerontology
- Geriatrics and Gerontology