Prevalence of Dementia in a Geriatric Palliative Care Unit

Abstract

Objectives: To determine the prevalence of dementia in a palliative care unit (PCU) and to determine whether there is a difference between length of stay (LOS) and Palliative Performance Scale (PPS) score in individuals admitted with a primary diagnosis of dementia compared to individuals admitted with other noncancer and cancer diagnoses.

Design: Descriptive retrospective chart review.

Setting: Geriatric PCU in an academic community geriatric hospital.

Participants: All individuals admitted to the Baycrest Health Sciences PCU from January 1, 2014, to September 1, 2016.

Measurements: Individuals with an admission diagnosis of cancer, noncancer, and dementia and their corresponding PPS scores were identified. Data were analyzed using descriptive statistics.

Results: A total of 780 patients were admitted to the PCU during the study period: 32 (4.1%) individuals had advanced dementia, 121 (15.5%) had a noncancer diagnosis, and 627 (80.4%) had cancer as the primary reason for admission. In the cancer and noncancer groups, 113 patients had a comorbid dementia diagnosis. The mean admission PPS score in patients with cancer was 36%, noncancer was 32.6%, and dementia was 23.8% ( P < .001). Mean LOS in patients with cancer was 32 days, noncancer patients was 34.3 days, and patients with advanced dementia was 33.3 days ( P = .90).

Conclusions: Individuals with an admission diagnosis of advanced dementia had a lower mean PPS score than individuals admitted with other noncancer and cancer diagnoses. There was no difference in the mean LOS between the 3 groups. Individuals with an admission diagnosis of advanced dementia should not be refused admission because of fear of outliving their prognosis.

Keywords: Palliative Performance Scale score; dementia; length of stay; palliative care; palliative care unit; prevalence.