Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 14;82(1):85.
doi: 10.1186/s13690-024-01316-2.

End-of-life care in German and Dutch nursing homes: a cross-sectional study on nursing home staff's perspective in 2022

Ann-Kathrin Bauer  1   2 , Alexander Maximilian Fassmer  3 , Sytse U Zuidema  4 , Sarah I M Janus  4 , Falk Hoffmann  3
Affiliations

End-of-life care in German and Dutch nursing homes: a cross-sectional study on nursing home staff's perspective in 2022

Ann-Kathrin Bauer et al. Arch Public Health. .

Erratum in

Abstract

Background: As society ages, the need for nursing home care is steadily increasing and end-of-life care of nursing home residents has become increasingly more important. End-of-life care differs between Germany and the neighbouring Netherlands. For example, a much higher proportion of German compared to Dutch nursing home residents is hospitalized at the end of life. Therefore, the aim of this study was to evaluate end-of-life care in German and Dutch nursing homes.

Methods: In this cross-sectional study, a postal survey was sent to 600 randomly selected German and Dutch nursing homes each and addressed to the nursing staff management. Participants were asked to estimate the percentage of nursing home residents whose wishes for emergency situations (e.g. cardiopulmonary resuscitation) are known and to indicate whether facilities offer advanced care planning (ACP). They were also asked to estimate whether general practitioners (GPs)/elder care physicians (ECPs) and nursing home staff are usually well trained for end-of-life care. Finally, participants were asked to estimate the proportion of nursing home residents who die in hospital rather than in the nursing home and to rate overall end-of-life care provision.

Results: A total of 301 questionnaires were included in the analysis; 199 from German and 102 from Dutch nursing homes (response 33.2% and 17.0%). German participants estimated that 20.5% of residents die in the hospital in contrast to the Dutch estimation of 5.9%. In German nursing homes, ACP is offered less often (39.2% in Germany, 75.0% in the Netherlands) and significantly fewer wishes for emergency situations of residents were known than in Dutch nursing homes. GPs were considered less well-trained for end-of-life care in Germany. The most important measures to improve end-of-life care were comparable in both countries.

Conclusion: Differences in (the delivery and knowledge of) end-of-life care between Germany and the Netherlands could be observed in this study. These could be due to structural differences (ECPs available 24/7 in the majority of Dutch nursing homes) and cultural differences (more discussion on quality of life versus life-sustaining treatments in the Netherlands). Due to these differences, a country-specific approach is necessary to improve end-of-life care.

Keywords: End-of-life care; Germany; Nursing home residents; Nursing staff; The Netherlands.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Respondents perceptions on whether general practitioners (GPs)/elder care physicians (ECPs) and nursing home staff are well trained in end-of-life care in % in Germany and the Netherlands (data from the 2022 CHARE-GD I study)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Nowossadeck S. Demografischer Wandel, Pflegebedürftige und der künftige Bedarf an Pflegekräften. Bundesgesundheitsbl. 2013;56(8):1040–7. - PubMed
    1. Moore KL, Boscardin WJ, Steinman MA, Schwartz JB. Patterns of chronic co-morbid medical conditions in older residents of U.S. nursing homes: differences between the sexes and across the agespan. J Nutr Health Aging. 2014;18(4):429–36. - PMC - PubMed
    1. van Oorschot B, Mücke K, Cirak A, Henking T, Neuderth S. Gewünschter sterbeort, patientenverfügungen und versorgungswünsche am lebensende: erste ergebnisse einer befragung von pflegeheimbewohnern. Z Gerontol Geriat. 2019;52(6):582–8. - PubMed
    1. U.S. Department of Health & Human Services (HHS), National Institute on Aging, (NIA). Providing Care and Comfort at the End of Life. Available at: https://www.nia.nih.gov/health/providing-comfort-end-life. Accessed 4 June 2023.
    1. Allers K, Hoffmann F, Schnakenberg R. Hospitalizations of nursing home residents at the end of life: a systematic review. Palliat Med. 2019;33(10):1282–98. - PMC - PubMed