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Clinical Trial
. 2018 Jul 18;13(7):e0200590.
doi: 10.1371/journal.pone.0200590. eCollection 2018.

Are older long term care residents accurately prognosticated and consequently informed about their prognosis? Results from SHELTER study data in 5 European countries

Maud Ten Koppel  1 , Bregje D Onwuteaka-Philipsen  1 , H Roeline Pasman  1 , Roberto Bernabei  2 , Iain Carpenter  3 , Michael D Denkinger  4 , Graziano Onder  2 , Henriëtte G van der Roest  5 , Eva Topinkova  6 , Hein P J van Hout  5
Affiliations
Clinical Trial

Are older long term care residents accurately prognosticated and consequently informed about their prognosis? Results from SHELTER study data in 5 European countries

Maud Ten Koppel et al. PLoS One. .

Abstract

Background: Informing residents in long term care facilities (LTCFs) about their prognosis can help them prepare for the end of life. This study aimed to examine which proportion of European LTCF residents, close to death, are accurately prognosticated and consequently informed about their prognosis; and to examine factors related to accurate prognostication and discussion of prognosis.

Methods: A subsample of SHELTER study data was used, consisting of: 500 residents from 5 European countries, who died within 6 months after their last assessment, and had a valid answer on the item 'End stage disease, 6 or fewer months to live'. This item was used to indicate whether an accurate prognosis was established and discussed with residents. Generalized estimating equations were used to examine factors related to establishment and discussion of accurate prognosis.

Results: 86.4% of residents close to death did not receive an accurate prognosis. Residents with cancer; fatigue; dehydration; and normal mode of nutritional intake were more likely to have an accurate prognosis established and discussed. Accurate prognostication and prognosis discussion was less likely for residents who: had a diagnosis under 'other'; initiated interactions; and residents from Germany, Italy and the Netherlands.

Conclusions: The great majority of residents close to death did not receive an accurate prognosis. Prognostication tools might help clinicians to increase their prognostic accuracy and communication training might help to discuss prognosis with residents.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Proportion of residents (not) accurately prognosticated and consequently informed about their prognosis, per country.
Fig 2
Fig 2. Proportion of residents (not) accurately prognosticated and consequently informed about their prognosis, according to months before death.
See this image and copyright information in PMC

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