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Multicenter Study
. 2010 Apr;60(573):171-9.
doi: 10.3399/bjgp10X483959.

Place of death for the 'oldest old': > or =85-year-olds in the CC75C population-based cohort

Jane Fleming  1 , Jun Zhao, Morag Farquhar, Carol Brayne, Stephen Barclay; Cambridge City Over-75s Cohort (CC75C) Study Collaboration
Affiliations
Multicenter Study

Place of death for the 'oldest old': > or =85-year-olds in the CC75C population-based cohort

Jane Fleming et al. Br J Gen Pract. 2010 Apr.

Abstract

Background: Deaths are rising fastest among the oldest old but data on their transitions in place of care at the end of life are scarce.

Aim: To examine the place of residence or care of > or =85 year-olds less than a year before death, and their place of death, and to map individual changes between the two.

Design of study: Population-based cohort study.

Setting: Cambridge City over-75s Cohort (CC75C) study, UK.

Method: Retrospective analysis of prospective data from males and females aged > or =85 years at death who died within a year of taking part in any CC75C survey (n = 320); death certificate linkage.

Results: Only 7% changed their address in their last year of life, yet 52% died somewhere other than their usual address at the time of death. Over two-thirds were living in the community when interviewed <1 year before death, but less than one-third who had lived at home died there (less than one-fifth in sheltered housing). Care homes were the usual address of most people dying there (77% in residential homes, 87% in nursing homes) but 15% of deaths in acute hospital came from care homes.

Conclusion: More than half the study sample of individuals of advanced old age had a change in their place of residence or care in their last year of life. These findings add weight to calls for improved end-of-life care in all settings, regardless of age, to avoid unnecessary transfers. The study data provide a baseline that can help plan and monitor initiatives to promote choice in location of care at the end of life for the very old.

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Figures

Figure 1
Figure 1
CC75C study: sampling frame for participants who died aged ≥85 years within a year of interview.
Online Figure 2
Online Figure 2
The ‘oldest old’ in their last year of life: how this analysis sample was constructed.
Figure 3
Figure 3
Movements between residential or care settings during the last year of life (n = 320 people who died aged ≥85) from their place of residence when interviewed less than a year before death, to their ‘usual address’ registered at death and where they died.
Figure 4
Figure 4
Study participants' usual address at death and place of death by age-band.
See this image and copyright information in PMC

References

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    1. Department of Health. Living well with dementia: a National Dementia Strategy. London: Department of Health; 2009.
    1. National Council for Palliative Care. Out of the shadows: end of life care for people with dementia. London: National Council for Palliative Care; 2009.
    1. National Audit Office. End of life care. London: House of Commons; 2008.

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